case_images: PMC10499279_01
case_images: Skull base and abdomen contrast-enhanced CT scans. (a) Expansive process of the right pterygomaxillary fossa, extended to the right maxillary sinus and right sphenoidal sinus (red arrow). (b) Axial scans and left kidney superior pole mass (red arrow). (c) Coronal sections and left kidney superior pole tumour with renal vein thrombosis (red arrow). CT: Computed tomography
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case_images: The right trigeminal nerve was involved by the lesion as well as the right internal carotid artery [Figure 1]. Thorax and abdomen contrast CT scans [Figure 1] disclosed a left kidney superior pole mass (6 cm in diameter) with thrombosis of the ipsilateral renal vein.
case_images: Endoscopic assessment disclosing a reddish, pulsating and highly vascularised mass on the posterior wall of the maxillary sinus
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case_images: The lesion was biopsed endoscopically, under general anaesthesia, through the posterior wall of the maxillary sinus, after caustication of the ipsilateral sphenopalatine artery [Figure 2].
case_images: (a) On the right, metastatic infiltration of atypical cellular elements, some of which have clear cytoplasm; on the left, normal tissue features (H and E, x10 magnification). (b-d) At the immunohistochemical investigation, the metastatic neoplasm was found to be positive for pancytokeratin (b, x20 magnification), vimentin (c, x20 magnification) and CD10 (d, x40 magnification). The present histological and immunohistochemical profile indicate a metastatic ccRCC. ccRCC: Clear-cell renal cell carcinoma
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case_images: Immunohistochemical analysis showed positivity for cytokeratin CAM 5.2, epithelial membrane antigen (EMA), vimentin, PAX8, CD10 and focal and weak positivity for pancytokeratin; it was negative for RCC, CD99 and desmin [Figure 3].