Management of solitary palatal metastasis from renal cell carcinoma

Background: A 68-year-old male diagnosed with left-side renal cell carcinoma, and in clinical remission for 3 years following a nephrectomy, presented with a 2-month history of progressive difficulty in swallowing, accompanied by a new growth in the palate. Examination revealed a 25 mm x 25 mm soft-tissue growth at the junction of the hard and soft palate. Systemic examination did not reveal any other evidence of cancer progression. Investigations: CT scans, nasopharyngoscopy, fine-needle aspiration of palatal lesion and immunohistochemistry of biopsy specimen. Diagnosis: Solitary palatal metastasis at the junction of the hard and soft palate from renal cell carcinoma. Management: Local, lesion-directed interferon therapy, repeat nasopharyngoscopy and regular clinical follow-up.