Parotid gland metastasis from renal cell carcinoma

OBJECTIVE: To discuss the diagnosis and management of metastatic renal cell carcinoma presenting as a parotid mass by studying such cases. STUDY DESIGN: Retrospective review. METHODS: Identification of 24 previously reported cases of renal cell carcinoma metastatic to the parotid gland in the English language literature and an analysis of a total of 25 patients including our case. RESULTS: Parotid metastasis was the initial presenting sign of the malignancy in the kidney in 14 of 25 (56%) cases; 11 of 25 (44%) cases presented with metachronous metastasis to the parotid. The most common presenting complaint was parotid mass. No case presented with facial paralysis. In three of six (50%) patients, fine-needle aspiration biopsy was diagnostic. CONCLUSIONS: In the majority of cases, parotid metastases are the first clinical sign of the renal cell carcinoma. Fine-needle aspiration biopsy can provide crucial information without parotidectomy as in our case. Parotidectomy with facial nerve preservation should be considered as a therapeutic option for solitary parotid metastasis.