Renal cell carcinoma presenting as epistaxis.

A case of renal cell carcinoma presenting as a nosebleed of three-week duration is described. Light microscopy of a nasal lesion showed a richly vascular tumor, forming glands and uniformly consisting of clear cells. Cytochemically and ultrastructurally, the presence of abundant lipid droplets and glycogen within the neoplastic cells indicated a renal origin. An extended clinical search for a primary kidney tumor was undertaken in view of a negative intravenous tomographic pyelography and renal scan findings. An angiogram finally revealed an intrarenal mass which was proven pathologically as a renal cell carcinoma.