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Successful Treatment of Paranasal Sinus Metastasis From Renal Cell Carcinoma With Immune Checkpoint Inhibitors and Radiotherapy: A Case Report.

IJU case reports 2026 Vol.9(2) p. e70156

Yamada S, Matsuo T, Tsuchiyama A, Nakanishi H, Mitsunari K, Ohba K, Mochizuki Y, Imamura R

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[INTRODUCTION] Renal cell carcinoma (RCC) metastasis to the paranasal sinuses is rare and lacks standard treatment, particularly for unresectable tumors.

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APA Yamada S, Matsuo T, et al. (2026). Successful Treatment of Paranasal Sinus Metastasis From Renal Cell Carcinoma With Immune Checkpoint Inhibitors and Radiotherapy: A Case Report.. IJU case reports, 9(2), e70156. https://doi.org/10.1002/iju5.70156
MLA Yamada S, et al.. "Successful Treatment of Paranasal Sinus Metastasis From Renal Cell Carcinoma With Immune Checkpoint Inhibitors and Radiotherapy: A Case Report.." IJU case reports, vol. 9, no. 2, 2026, pp. e70156.
PMID 41726848
DOI 10.1002/iju5.70156

Abstract

[INTRODUCTION] Renal cell carcinoma (RCC) metastasis to the paranasal sinuses is rare and lacks standard treatment, particularly for unresectable tumors. We report a case of sphenoid sinus metastasis with sarcomatoid differentiation successfully managed with radiation therapy and immunotherapy.

[CASE PRESENTATION] A 59-year-old male who had undergone left radical nephrectomy for RCC 13 years prior presented with acute left eye pain and tinnitus. Contrast-enhanced computed tomography (CT) revealed a hyper vascular sphenoid sinus mass with osseous destruction. Biopsy confirmed metastatic RCC with sarcomatoid differentiation. Given rapid symptom progression, intensity-modulated radiation therapy (39 Gy in 13 fractions) was initiated, followed by immunotherapy with nivolumab and ipilimumab. The patient developed complete blindness, which gradually improved during treatment. Serial CT showed a partial response sustained through four cycles. Subsequent 37 cycles of maintenance nivolumab showed persisting tumor reduction.

[CONCLUSION] Radiation with nivolumab and ipilimumab may be effective for unresectable paranasal sinus metastases of RCC.

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