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Parotid gland metastasis from renal cell carcinoma: An unusual site for metastasis

Mustafa Kaplan, Murat Caloglu, Vuslat Y. Caloglu, Tevfik Aktoz, Ufuk Usta, Hakan Karagöl, Osman Inci

Am J Case Rep 2008; 9:316-320

ID: 864067

Published: 2008-07-08

Background: Renal cell carcinoma accounts for more than 90% of malignant kidney tumors and the common sites for metastases include lung, liver, bone, brain and skin. Metastasis to the parotid gland is considered extremely rare. The most common lesions to metastasize to the parotid gland are skin, breast, lung, and thyroid cancers.
Case Report: We report a case of solitary parotid metastasis from renal cell carcinoma in a 68-year-old man. Patient was referred to the clinic with a complaint of painless right preauricular mass which had been gradually increasing in size for a year. An approximately 20 cm left sided mass was appreciated on examination of the patient’s abdomen. Computed tomography (CT) scan of craniocervical region demonstrated a parotid mass measuring 8×10×9 cm with invasion of the pterygoid muscles. A subsequent abdominal CT revealed a left renal lesion measuring 13×18 cm. Since the parotid gland was assumed unresectable, the patient elected to undergo a left radical nephrectomy. Moreover the sections of the right parotid mass showed similar architecture and histomorphology to the renal tumor.
Conclusions: The differential diagnosis, histochemical and immunohistochemical features, and treatment of this lesion are discussed. It seems that the initial diagnosis with parotid metastasis, the larger the size of both the primary and metastatic tumor, and immunohistopathological features of the tumor, appear to have led to the poor prognosis in the present case. Although parotid masses resulting from RCC metastasis are rare, one should be aware of the possibility when a clear cell neoplasm is disclosed in the parotid specimen.

Keywords: Parotid Gland, renal cell carcinoma, metastasis