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Joseph R. Burns, M.D.; Margaret H. Edwards, M.D.; Johannes F. Pessel, M.D.; Donald H. Cowlbeck, M.D.
JAMA. 1956;161(3):226-227. doi:10.1001/jama.1956.62970030009009c.
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The initial symptom of a renal carcinoma is often that of a metastatic lesion.1 While renal tumors metastasize chiefly to bones and lungs, they occasionally choose bizarre sites for a solitary metastasis, such as the thyroid, tonsil, tongue, skin, and phalanges.2 In the case reported below the nasopharynx was the site of an unusual metastatic lesion, with epistaxis as the presenting symptom.

Report of a Case  A 74-year-old woman had sudden onset of profuse nasal bleeding while sitting at home and was brought to Mercer Hospital accident ward on Feb. 19, 1955, where anterior and posterior nasal packs were inserted. Because of blood loss, she was admitted for transfusions. The medical history included hypertension of several years' duration, copious bleeding from a cut on the right foot a year before, but no previous epistaxis. Some urinary frequency and nocturia had been noted "recently."Physical examination disclosed a frail


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