Department of Neurosurgery, Dong Gwang Ju Woori Hospital, Gwangju, Korea.
Spine (Phila Pa 1976). 2009 Nov 15;34(24):E892-5. doi: 10.1097/BRS.0b013e3181b34e6c.
Case description.
To describe a case of intradural metastasis from a renal cell carcinoma (RCC) spread to the cauda equina, and review the pertinent medical literature.
Intradural spinal metastasis is rare, accounting for 6% of all spinal metastases. Only 7 cases of intradural metastasis from a RCC to the cauda equina have been previously reported.
A 41-year-old male presented with a 1-month history of severe back pain radiating to both legs. The patient underwent a right nephrectomy for treatment of a RCC 1-year before admission. Magnetic resonance imaging showed a well-demarcated, intradural extramedullary mass at the L2 vertebra.
After a total laminectomy, total excision of the tumor was achieved followed by rapid improvement of the back pain. The tumor was histologically verified as metastatic RCC, identical to that of a previous tumor specimen. The patient was asymptomatic on the 1-year follow-up.
Although the majority of cauda equina tumors are primary tumors, intradural metastasis should be considered before surgery in patients with previously treated RCC.
病例描述。
描述一例肾细胞癌（RCC）向马尾椎管内转移的病例，并复习相关医学文献。
椎管内脊髓转移较为罕见，占所有脊髓转移的 6%。先前仅有 7 例 RCC 向马尾椎管内转移的病例报道。
一名 41 岁男性，因严重背痛伴双下肢放射痛 1 个月就诊。患者 1 年前因 RCC 行右肾切除术。磁共振成像显示 L2 椎体水平有一界限清楚的硬脊膜外髓内肿块。
行全椎板切除术，肿瘤全切除后，背痛迅速缓解。肿瘤的组织学证实为转移性 RCC，与之前的肿瘤标本相同。患者在 1 年随访时无症状。
虽然大多数马尾肿瘤为原发性肿瘤，但对于有既往 RCC 治疗史的患者，在手术前应考虑硬脊膜内转移。
