Zhou Minerva H, Dunn Gavin P, Osbun Joshua W, Cross DeWitte T, Moran Christopher J, Dacey Ralph G, Kansagra Akash P
1 12275 School of Medicine, Washington University , St. Louis, MO, USA.
2 12275 Department of Neurological Surgery, Washington University , St. Louis, MO, USA.
Interv Neuroradiol. 2018 Apr;24(2):220-224. doi: 10.1177/1591019917740353. Epub 2017 Nov 9.
We report a case of renal cell carcinoma (RCC) metastasis to the calvarium and describe a strategy for percutaneous embolization of hypervascular calvarial tumors with intracranial extension. An elderly patient with history of RCC presented with left-sided weakness. Imaging studies showed a large right frontoparietal calvarial mass with intra- and extracranial extension. The tumor was devascularized by direct puncture tumor embolization using Onyx 18, allowing subsequent operative resection without significant blood loss or the need for flap reconstruction of the scalp. Compared to more common endovascular approaches, direct-needle puncture embolization of transcalvarial masses may offer lower risk of injury to scalp vessels and underlying brain parenchyma.
我们报告了一例肾细胞癌（RCC）转移至颅骨的病例，并描述了一种针对具有颅内延伸的高血运颅骨肿瘤进行经皮栓塞的策略。一名有RCC病史的老年患者出现左侧肢体无力。影像学检查显示右侧额顶叶颅骨有一个巨大肿块，向颅内和颅外延伸。通过使用Onyx 18直接穿刺肿瘤栓塞使肿瘤去血管化，从而使后续手术切除时无明显失血，也无需进行头皮皮瓣重建。与更常见的血管内方法相比，经颅骨肿块的直接针穿刺栓塞可能对头皮血管和下方脑实质造成损伤的风险更低。
