鼻出血を主訴とした腎癌の篩骨蜂巣転移症例

A Case of Renal Cell Carcinoma with Metastasis to the Ethmoid Air Cells

I．はじめに

　鼻・副鼻腔に発生する腫瘍は大部分が原発性であり，他臓器からの転移性腫瘍はきわめて稀^1,2）とされている。今回われわれは難治性の鼻出血をきたし，手術により過去に治療を受けた腎癌の篩骨蜂巣への転移と診断された症例を経験したので，若干の考察を加えて報告する。

A 58-year-old man was admitted because of severe epistaxis. He underwent left nephrectomy 18 months ago under the diagnosis of renal cell carcinoma. Tomography and CT scanning of the paranasal sinuses disclosed abnormal findings in the right ethmoid air cells. CAG revealed a hypervascular tumor shadow in the same region. The tumor was removed via the external ap-proach and diagnosed as metastatic clear cell carcinoma originated from the kidney.

It is thought that carcinoma rarely metastasizes to the nose and paranasal sinuses. But renal cell carcinoma often metastasizes to the head and neck region, and this fact should be considered when diagnosis of the head and neck cancer is made.