Orbital aneurysmal bone cyst in a patient with renal cell carcinoma.

A 43-year-old man with presumed renal cell carcinoma who was found to have an asymptomatic hot spot in his right zygoma on a bone scan during a metastatic evaluation. At the time of nephrectomy, an excisional biopsy of the lateral orbital wall was performed to rule out solitary metastasis of his renal cell carcinoma. The lateral wall was reconstructed with a rib autograft and multiple rigid fixation. Histopathologic examination of the specimen showed a fibrous matrix with large, dilated, sinusoidal, vascular channels typical of an aneurysmal bone cyst. In the absence of metastasis, the five-year survival rate is approximately 90% with nephrectomy alone.