phenylephrine-hydrochloride and Carcinoma--Renal-Cell

Metastatic renal cell carcinoma (RCC) in the nose and paranasal sinuses is very rare. We report an unusual case of metastatic RCC that presented as recurrent epistaxis ten years after curative nephrectomy. The purpose of this report is to draw the attention of clinicians to the possibility of metastatic RCC in patients with recurrent epistaxis and nasal mass. We also discuss treatment options and review the relevant literature.

Topics: Adult; Carcinoma, Renal Cell; Chemoradiotherapy; Diagnosis, Differential; Epistaxis; Humans; Indoles; Kidney Diseases; Male; Neoplasm Metastasis; Nose; Nose Neoplasms; Positron-Emission Tomography; Pyrroles; Recurrence; Sunitinib; Tomography, X-Ray Computed

Ultrasound is commonly performed to diagnose pathological processes of the neck and the salivary glands. In contrast, pathological changes of the sinuses and the bony structures of the face are only rarely examined sonographically. This paper deals with the diagnostic scope of ultrasound in the case of orbital and nasal fractures as well as for cases of sinus pathology excluding acute sinusitis. 51 patients with different diseases of this area were examined using US and X-ray or CT scan. Fractures of the nose could all be diagnosed correctly by ultrasound, which is of clinical importance if children or pregnant patients are examined. Blow-out fractures of the orbit were not detected. In contrast, pathological changes of the orbit itself could be distinguished sufficiently well from those infiltrating the orbit and originating from the sinuses. Real-time examination allows the detection of infiltration of orbital muscles and the bulb of the eye better than any other imaging method.

Topics: Carcinoma, Renal Cell; Female; Fractures, Bone; Humans; Kidney Neoplasms; Male; Neoplasm Metastasis; Nose; Nose Diseases; Nose Neoplasms; Paranasal Sinus Diseases; Paranasal Sinuses; Reproducibility of Results; Tomography, X-Ray Computed; Ultrasonography

Topics: Aged; Biopsy; Carcinoma, Renal Cell; Humans; Kidney Neoplasms; Male; Nose; Nose Neoplasms

Submucosal dissection of the nasal septum is often performed as part of the transseptal approach to the sella. To evaluate whether this submucosal dissection is a necessary component of this operation, we compared the morbidity of a direct transmucosal endonasal approach to that of the transseptal approach in patients undergoing pituitary surgery.. Forty-one consecutive patients undergoing pituitary surgery from January 1996 to March 1999 were included in this study. The first 21 patients underwent the standard transseptal operation through either a sublabial or columellar incision. The latter 20 patients were operated on through an endoscopically guided, direct endonasal exposure, without any submucosal dissection of the nasal septum. The operative morbidity, the duration of surgery, and the length of hospitalization for each group were compared.. The sphenoid sinus exposure obtained through the endonasal route was comparable with the transseptal approach and was adequate for resection of most pituitary tumors. Although the morbidity of the two approaches was similar, patients undergoing the endonasal operation had less postoperative facial pain. Furthermore, the endonasal approach significantly decreased the length of the operation (116 minutes vs. 161 minutes, p = 0.002) and the duration of hospitalization (3.6 vs. 5.1 days, p = 0.003) as compared with the transseptal route.. Morbidity of the endonasal approach to the sphenoid sinus is comparable to that of a conventional transseptal approach. By eliminating the submucosal dissection, the endonasal approach reduces postoperative facial discomfort and decreases length of surgery and hospitalization.

Topics: Adenoma; Adult; Carcinoma, Renal Cell; Central Nervous System Cysts; Craniopharyngioma; Endoscopy; Female; Fibrosis; Germinoma; Humans; Male; Middle Aged; Neurosurgical Procedures; Nose; Pituitary Neoplasms; Treatment Outcome