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肾细胞癌硬膜内马尾转移:1例病例报告并文献复习10例

Intradural cauda equina metastasis of renal cell carcinoma: a case report with literature review of 10 cases.

作者信息

Ji Gyu Yeul, Oh Chang Hyun, Kim Se-Hoon, Shin Dong Ah, Kim Keung Nyun

机构信息

Department of Neurosurgery, Guro Teun Teun Hospital, Seoul, Korea.

出版信息

Spine (Phila Pa 1976). 2013 Aug 15;38(18):E1171-4. doi: 10.1097/BRS.0b013e31829cef66.

Abstract

STUDY DESIGN

Case report with literature review.

OBJECTIVE

To describe a rare case of intradural spinal metastasis from renal cell carcinoma (RCC) spread to the cauda equina, and to discuss the clinical features of metastatic RCC in the cauda equina from the data available in the literature.

SUMMARY OF BACKGROUND DATA

Intradural spinal metastasis is rare, representing 6% of all spinal metastasis. Indeed, intradural metastasis from a RCC to the cauda equina is extremely rare with previously only 9 case reports.

METHODS

A 68-year-old male presented with a 2-month history of worsening lower back pain radiating to both legs. The patient had undergone nephrectomy for the treatment of the clear cell RCC 16 years before admission. Magnetic resonance imaging showed a well-defined intradural extramedullary mass in the cauda equina at T12 to L1.

RESULTS

The pathological examination displayed metastatic clear cell RCC. Additional imaging studies showed no metastatic in other locations. The patient was discharged without neurological deficit and pain after the operation, and maintained an optimal condition for 2 years.

CONCLUSION

When a lesion of the cauda equina presents, intradural metastasis should be in the differential diagnosis in patients who had been previously treated for RCC although any other metastatic lesion was not observed.

LEVEL OF EVIDENCE

N/A.

摘要

研究设计

病例报告并文献综述。

目的

描述一例罕见的肾细胞癌硬膜内脊髓转移至马尾神经的病例,并根据文献资料探讨马尾神经转移性肾细胞癌的临床特征。

背景资料总结

硬膜内脊髓转移罕见,占所有脊髓转移的6%。实际上,肾细胞癌硬膜内转移至马尾神经极为罕见,此前仅有9例病例报告。

方法

一名68岁男性,有2个月下背部疼痛加重并放射至双腿的病史。患者在入院前16年因透明细胞肾细胞癌接受了肾切除术。磁共振成像显示在T12至L1水平的马尾神经有一个边界清晰的硬膜内髓外肿块。

结果

病理检查显示为转移性透明细胞肾细胞癌。其他影像学检查未显示其他部位有转移。患者术后无神经功能缺损及疼痛出院,并维持良好状态2年。

结论

当出现马尾神经病变时,对于既往有肾细胞癌治疗史的患者,即使未观察到其他转移病灶,也应在鉴别诊断中考虑硬膜内转移。

证据级别

无。

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