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Unusual metastasis to the cauda equina from renal cell carcinoma.
Spine (Phila Pa 1976). 2003 Mar 15; 28(6):E114-7.S

Abstract

STUDY DESIGN

This is a case report of a patient with renal cell carcinoma and intradural metastasis to the cauda equina.

OBJECTIVE

To present a rare case of an intradural metastasis from renal cell carcinoma and to discuss the clinical features of metastatic tumors in the cauda equina and the possible mechanism of the tumor spread to the cauda equina.

SUMMARY OF BACKGROUND DATA

Intradural spinal metastasis has been rarely reported in the English literature. Only two reports that describe the spread of metastatic renal cell carcinoma to the cauda equina have been published.

METHODS

A 61-year-old man who underwent a nephrectomy for the treatment of renal cell carcinoma presented with worsening low back pain that radiated to both legs. Magnetic resonance imaging showed an ill-defined tumor mass in the cauda equina at L3. After a recapping T-saw laminoplasty of L3 was performed, the tumor was excised and the nerves involved in the tumor were transected.

RESULTS

Pathologic examination showed papillary renal cell carcinoma with identical histology to the primary tumor. The patient's low back pain and radiating leg pain were relieved after operating.

CONCLUSION

The majority of cauda equina tumors are primary tumors, and metastases are very rare. Intradural spinal metastasis pain is a characteristic cramping pain provoked by light percussion on the lumbar spine, becoming severe when sleeping in the flexion or sitting position. Magnetic resonance imaging is a useful tool for detecting intraspinal metastasis when the patient is complaining of a unique pain. A recapping T-saw laminoplasty to preserve posterior elements with tumor removal is feasible for relieving pain and demonstrating the pathology.

Authors+Show Affiliations

Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

12642774

Citation

Takada, Toru, et al. "Unusual Metastasis to the Cauda Equina From Renal Cell Carcinoma." Spine, vol. 28, no. 6, 2003, pp. E114-7.
Takada T, Doita M, Nishida K, et al. Unusual metastasis to the cauda equina from renal cell carcinoma. Spine (Phila Pa 1976). 2003;28(6):E114-7.
Takada, T., Doita, M., Nishida, K., Miura, J., Yoshiya, S., & Kurosaka, M. (2003). Unusual metastasis to the cauda equina from renal cell carcinoma. Spine, 28(6), E114-7.
Takada T, et al. Unusual Metastasis to the Cauda Equina From Renal Cell Carcinoma. Spine (Phila Pa 1976). 2003 Mar 15;28(6):E114-7. PubMed PMID: 12642774.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Unusual metastasis to the cauda equina from renal cell carcinoma. AU - Takada,Toru, AU - Doita,Minoru, AU - Nishida,Kotaro, AU - Miura,Juichi, AU - Yoshiya,Shinichi, AU - Kurosaka,Masahiro, PY - 2003/3/19/pubmed PY - 2003/3/29/medline PY - 2003/3/19/entrez SP - E114 EP - 7 JF - Spine JO - Spine (Phila Pa 1976) VL - 28 IS - 6 N2 - STUDY DESIGN: This is a case report of a patient with renal cell carcinoma and intradural metastasis to the cauda equina. OBJECTIVE: To present a rare case of an intradural metastasis from renal cell carcinoma and to discuss the clinical features of metastatic tumors in the cauda equina and the possible mechanism of the tumor spread to the cauda equina. SUMMARY OF BACKGROUND DATA: Intradural spinal metastasis has been rarely reported in the English literature. Only two reports that describe the spread of metastatic renal cell carcinoma to the cauda equina have been published. METHODS: A 61-year-old man who underwent a nephrectomy for the treatment of renal cell carcinoma presented with worsening low back pain that radiated to both legs. Magnetic resonance imaging showed an ill-defined tumor mass in the cauda equina at L3. After a recapping T-saw laminoplasty of L3 was performed, the tumor was excised and the nerves involved in the tumor were transected. RESULTS: Pathologic examination showed papillary renal cell carcinoma with identical histology to the primary tumor. The patient's low back pain and radiating leg pain were relieved after operating. CONCLUSION: The majority of cauda equina tumors are primary tumors, and metastases are very rare. Intradural spinal metastasis pain is a characteristic cramping pain provoked by light percussion on the lumbar spine, becoming severe when sleeping in the flexion or sitting position. Magnetic resonance imaging is a useful tool for detecting intraspinal metastasis when the patient is complaining of a unique pain. A recapping T-saw laminoplasty to preserve posterior elements with tumor removal is feasible for relieving pain and demonstrating the pathology. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/12642774/Unusual_metastasis_to_the_cauda_equina_from_renal_cell_carcinoma_ L2 - https://doi.org/10.1097/01.BRS.0000049910.72881.A0 DB - PRIME DP - Unbound Medicine ER -