Vol.95 No.8 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 95 No. 8 August 2002
Temporal Bone Metastasis of Renal Cell Carcinoma;
A Case Report
Kaori Kayano
(Rakuwakai Marutamachi Hospital)
Yasushi Murakami
(Kyoto Local Medical Interdisciplinary Research Institute)
Renal cell carcinomas rarely metastasize to the bones of the skull. We report here the case of a renal cell carcinoma that metastasized to the temporal bone.
The patient was an 85-year-old female who had been diagnosed with renal cell carcinoma and had undergone a left nephrectomy in October 1987. In December 2000, she noticed a swelling in her left temporal region. The tumor was 35×50 mm, elastic and soft, and accompanied with a heartbeat upon palpation. A blood-filled tumor which had destroyed the left temporal bone without penetrating into the dura mater, with metastasis to the right ribs, was detected by CT, MRI, US and cerebral angiography (radiological features). It was diagnosed as a metastatic renal cell carcinoma of the alveolar, common clear cell subtype by open biopsy. We judged that it was impossible to perform a curative resection, so the patient was treated internally with cimetidine which has an immunity activation action. It was also important to maintain her quality of life and to boost her immunity.
Renal cell carcinomas tend to be highly metastatic, and metastasis after more than ten years is not uncommon. Therefore, it is prudent to always take renal cell carcinoma into consideration in the differential diagnosis of blood-filled tumors. In addition, caution should be exercised since these tumors are friable and tend to bleed during diagnosis and treatment.
Key words : temporal bone metastasis, renal cell carcinoma, blood-filled tumor, cimetidine