J Korean Soc Radiol.  2012 Feb;66(2):123-127. 10.3348/jksr.2012.66.2.123.

Initial Presentation of Renal Cell Carcinoma as a Metastatic Mass within the Masseter Muscle: A Case Report and Literature Review

• Bae KE
• Lee HB
• Cho WH
• Kim JH
• Lee J
• Kang MJ
• Kim HJ

• KMID: 1439402
• DOI: http://doi.org/10.3348/jksr.2012.66.2.123

Abstract

Renal cell carcinoma (RCC) is often concomitant with distant metastasis, and these metastases are the first sign of an otherwise occult primary. Whereas metastasis of RCC to the head and neck has been reported, metastasis to the masseter muscle, which is composed of skeletal muscle, is quite rare. We now report the case of a 66-year-old man who had a past history of pulmonary tuberculosis, with RCC metastasis of a well-defined intensely enhancing hypervascular mass in the masseter muscle as the initial presentation. We present the imaging findings of this case and a literature review about radiologic differential diagnosis of intramasseteric masses.

MeSH Terms

Aged
Carcinoma, Renal Cell
Diagnosis, Differential
Head
Humans
Masseter Muscle
Muscle, Skeletal
Neck
Neoplasm Metastasis
Tuberculosis, Pulmonary

Reference

1. Pritchyk KM, Schiff BA, Newkirk KA, Krowiak E, Deeb ZE. Metastatic renal cell carcinoma to the head and neck. Laryngoscope. 2002. 112:1598–1602.

2. Yiotakis J, Hantzakos A, Kostakopoulos A, Adamopoulos G. Intramasseteric metastasis of renal cell carcinoma. J Laryngol Otol. 2001. 115:65–67.

3. Sgouras ND, Gamatsi IE, Porfyris EA, Lekka JA, Harkiolakis GC, Nikolopoulou SM, et al. An unusual presentation of a metastatic hypernephroma to the frontonasal region. Ann Plast Surg. 1995. 34:653–656.

4. Nakagawa H, Mizukami Y, Kimura H, Watanabe Y, Kuwayama N. Metastatic masseter muscle tumour: a report of a case. J Laryngol Otol. 1996. 110:172–174.

5. Gal TJ, Ridley MB, Arrington JA, Muro-Cacho C. Renal cell carcinoma presenting as a masseteric space mass. Am J Otolaryngol. 1997. 18:280–282.

6. Chong VF, Fan YF. Pictorial review: radiology of the masticator space. Clin Radiol. 1996. 51:457–465.

7. Lim SM, Lee HK, Shin JH, Kim JK, Kim DH, Choi CG, et al. CT, MR and angiographic findings of hemangiopericytomas. J Korean Radiol Soc. 1999. 41:9–16.

8. Connor SE, Davitt SM. Masticator space masses and pseudomasses. Clin Radiol. 2004. 59:237–245.

9. Lin SP, Bierhals AJ, Lewis JS Jr. Best cases from the AFIP: metastatic renal cell carcinoma. Radiographics. 2007. 27:1801–1807.

10. Marulli G, Sartori F, Bassi PF, dal Moro F, Gino Favaretto A, Rea F. Long-term results of surgical management of pulmonary metastases from renal cell carcinoma. Thorac Cardiovasc Surg. 2006. 54:544–547.