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DOI: 10.1055/s-0036-1579629
Sunitinib as Neoadjuvant Chemotherapy in the Management of Metastatic Renal Cell Carcinoma Mimicking a Glomus Vagale Tumor in the Head and Neck: A Case Report and Review of Literature
Publication History
08 August 2015
03 January 2016
Publication Date:
26 May 2016 (online)
![](https://www.thieme-connect.de/media/jnlsr/201602/lookinside/thumbnails/10-1055-s-0036-1579629_150056-1.jpg)
Abstract
Background Metastatic renal cell carcinoma (RCC) of the head and neck with intracranial extension is rare and may pose difficulties to the diagnosis and management.
Method We describe a unique case of a 76-year-old man with a metastatic RCC to the neck and lateral skull base with intracranial extension presenting with Collet-Sicard syndrome 8 years after initial diagnosis. The radiologic features were consistent with the diagnosis of a glomus vagale tumor on the basis of clinical and radiologic features.
Results Despite radiotherapy, the intracranial extension progressed in size, resulting in early hydrocephalus. Sunitinib, a novel tyrosine kinase inhibitor, was instituted to treat the glomus vagale tumor with a marked reduction in tumor volume and resolution of the early hydrocephalus. The surgical resection of the tumor with its intracranial extension was achieved without additional postoperative morbidity. The histopathologic diagnosis surprisingly demonstrated metastatic RCC.
Conclusion We present a case of metastatic RCC to the head and neck region mimicking a glomus vagale tumor and describe the first use of sunitinib as a neoadjuvant chemotherapy to achieve a single-stage radical en bloc resection of the tumor mass.
Keywords
skull base metastasis - renal cell carcinoma - sunitinib - cranial nerve palsy - glomus vagale tumorNote
Below manuscript has not been previously published in whole or in part or submitted elsewhere for review.
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References
- 1 Ogunyemi O, Rojas A, Hematpour K, Rogers D, Head C, Bennett C. Metastasis of genitourinary tumors to the head and neck region. Eur Arch Otorhinolaryngol 2010; 267 (2) 273-279
- 2 Wahner-Roedler DL, Sebo TJ. Renal cell carcinoma: diagnosis based on metastatic manifestations. Mayo Clin Proc 1997; 72 (10) 935-941
- 3 Miyamoto R, Helmus C. Hypernephroma metastatic to the head and neck. Laryngoscope 1973; 83 (6) 898-905
- 4 Gottlieb MD, Roland Jr JT. Paradoxical spread of renal cell carcinoma to the head and neck. Laryngoscope 1998; 108 (9) 1301-1305
- 5 Pritchyk KM, Schiff BA, Newkirk KA, Krowiak E, Deeb ZE. Metastatic renal cell carcinoma to the head and neck. Laryngoscope 2002; 112 (9) 1598-1602
- 6 Langille G, Taylor SM, Bullock MJ. Metastatic renal cell carcinoma to the head and neck: summary of 21 cases. J Otolaryngol Head Neck Surg 2008; 37 (4) 515-521
- 7 Morvan JB, Veyrières JB, Mimouni O, Cathelinaud O, Allali L, Verdalle P. Clear-cell renal carcinoma metastasis to the base of the tongue and sphenoid sinus: two very rare atypical ENT locations. Eur Ann Otorhinolaryngol Head Neck Dis 2011; 128 (2) 91-94
- 8 Boileau MA, Grotta JC, Borit A , et al. Metastatic renal cell carcinoma simulating glomus jugulare tumor. J Surg Oncol 1987; 35 (3) 201-203
- 9 De Vos C, Gerard JM, Decat M, Gersdorff M. Metastatic renal cell carcinoma to the temporal bone: case report. B-ENT 2005; 1 (1) 43-46
- 10 Prochilo T, Savelli G, Bertocchi P , et al. Targeting VEGF-VEGFR pathway by sunitinib in peripheral primitive neuroectodermal tumor, paraganglioma and epithelioid hemangioendothelioma: three case reports. Case Rep Oncol 2013; 6 (1) 90-97
- 11 Bourcier ME, Vinik AI. Sunitinib for the treatment of metastatic paraganglioma and vasoactive intestinal polypeptide-producing tumor (VIPoma). Pancreas 2013; 42 (2) 348-352
- 12 Joshua AM, Ezzat S, Asa SL , et al. Rationale and evidence for sunitinib in the treatment of malignant paraganglioma/pheochromocytoma. J Clin Endocrinol Metab 2009; 94 (1) 5-9
- 13 Hahn NM, Reckova M, Cheng L, Baldridge LA, Cummings OW, Sweeney CJ. Patient with malignant paraganglioma responding to the multikinase inhibitor sunitinib malate. J Clin Oncol 2009; 27 (3) 460-463
- 14 Chow WH, Dong LM, Devesa SS. Epidemiology and risk factors for kidney cancer. Nat Rev Urol 2010; 7 (5) 245-257
- 15 Ridge CA, Pua BB, Madoff DC. Epidemiology and staging of renal cell carcinoma. Semin Intervent Radiol 2014; 31 (1) 3-8
- 16 Vanharanta S, Buchta M, McWhinney SR , et al. Early-onset renal cell carcinoma as a novel extraparaganglial component of SDHB-associated heritable paraganglioma. Am J Hum Genet 2004; 74 (1) 153-159
- 17 Williamson SR, Eble JN, Amin MB , et al. Succinate dehydrogenase-deficient renal cell carcinoma: detailed characterization of 11 tumors defining a unique subtype of renal cell carcinoma. Mod Pathol 2015; 28 (1) 80-94
- 18 Koutnouyan HA, Rumore GJ, Kahn JM. Skull metastasis from renal cell carcinoma. Case report and literature review. Ann Otol Rhinol Laryngol 1998; 107 (7) 598-602
- 19 Yeh HC, Yang SF, Ke HL, Lee KS, Huang CH, Wu WJ. Renal cell carcinoma presenting with skull metastasis: a case report and literature review. Kaohsiung J Med Sci 2007; 23 (9) 475-479
- 20 Bone I, Hadley DM. Syndromes of the orbital fissure, cavernous sinus, cerebello-pontine angle, and skull base. J Neurol Neurosurg Psychiatry 2005; 76 (Suppl. 03) iii29-iii38
- 21 Robbins KT, Fenton RS. Jugular foramen syndrome. J Otolaryngol 1980; 9 (6) 505-516
- 22 Löwenheim H, Koerbel A, Ebner FH, Kumagami H, Ernemann U, Tatagiba M. Differentiating imaging findings in primary and secondary tumors of the jugular foramen. Neurosurg Rev 2006; 29 (1) 1-11 , discussion 12–13
- 23 Motzer RJ, Rini BI, Bukowski RM , et al. Sunitinib in patients with metastatic renal cell carcinoma. JAMA 2006; 295 (21) 2516-2524
- 24 Browne JD, Fisch U, Valavanis A. Surgical therapy of glomus vagale tumors. Skull Base Surg 1993; 3 (4) 182-192