Metastatic Renal Cell Carcinoma in the Sinonasal Region

Sinonasal region is an exceptional site for metastatic tumors. Renal cell carcinoma is known to metastasise to the most unusual sites, the sinonasal region being one of them. Clear cell carcinoma is its most common histologic variant. A sixty year old male presented with epistaxis and nasal obstruction. Clinical examination and CT scan revealed a vascular tumor in the right nasal cavity and maxillary sinus. The tumor was resected and sent for histopathological examination. A diagnosis of metastatic clear cell renal cell carcinoma was made and confirmed with immunohistochemistry (IHC). The pathologic diagnosis was made without prior knowledge of the primary tumor in the kidney. Very few cases of metastatic renal cell carcinoma in the sinonasal region have been reported in literature. We present this case to document its occurrence, highlight the rarity and briefly discuss the differential diagnoses of clear cell carcinoma in the sinonasal area, based on morphology and IHC.