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Metastatic renal cell carcinoma, with a radiographically occult primary tumor, presenting in the operative site of a thoracic meningioma: long-term follow-up: Case report.
J Neurosurg Spine. 2014 Oct; 21(4):628-33.JN

Abstract

Lesions metastatic to the site of a meningioma resection from a different primary tumor are rare. Metastasis of a tumor without a known primary tumor is also rare. Metastasis of a renal cell carcinoma, without an identifiable primary tumor, to the bed of a meningioma resection has not been previously reported. The authors describe the case of a 54-year-old man who presented with decreased sensory and motor function in the lower extremities. He underwent T3-5 laminectomies and gross-total removal of an intradural, extramedullary meningioma. The postoperative course was uneventful, and the patient regained full neurological function. After a 3-year period, he developed progressive upper thoracic pain and lower-extremity paresthesias. Imaging studies showed an epidural mass at the T2-4 levels and what appeared to be blastic involvement of the T2-4 vertebrae. A metastatic workup was negative. Emergency revision laminectomies yielded a fibrous, nonvascular mass. Neuropathology was consistent with metastatic renal cell carcinoma. After 6 months, the patient's symptoms of pain and paresthesias recurred. Repeat excision, with decompression of the spinal cord, revealed tumor cells morphologically and immunophenotypically similar to those obtained from the prior surgery. Cytogenetic analysis confirmed the presence of metastatic renal cell carcinoma. A novel case of an epidural metastatic renal cell carcinoma, of unknown primary origin, in the same operative bed of a previously resected intradural, extramedullary meningioma of the thoracic spine is reported.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Heary RF
Departments of 1 Neurological Surgery.
Agarwal N
No affiliation info available
Barrese JC
No affiliation info available
Barry MT
No affiliation info available
Baisre A
No affiliation info available

MeSH

Carcinoma, Renal CellDecompression, SurgicalFatal OutcomeHumansImmunohistochemistryLaminectomyMagnetic Resonance ImagingMaleMeningeal NeoplasmsMeningiomaMiddle AgedNeoplasms, Unknown PrimarySpinal Cord NeoplasmsThoracic VertebraeTomography, X-Ray Computed

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

25014504

Citation

Heary, Robert F., et al. "Metastatic Renal Cell Carcinoma, With a Radiographically Occult Primary Tumor, Presenting in the Operative Site of a Thoracic Meningioma: Long-term Follow-up: Case Report." Journal of Neurosurgery. Spine, vol. 21, no. 4, 2014, pp. 628-33.
Heary RF, Agarwal N, Barrese JC, et al. Metastatic renal cell carcinoma, with a radiographically occult primary tumor, presenting in the operative site of a thoracic meningioma: long-term follow-up: Case report. J Neurosurg Spine. 2014;21(4):628-33.
Heary, R. F., Agarwal, N., Barrese, J. C., Barry, M. T., & Baisre, A. (2014). Metastatic renal cell carcinoma, with a radiographically occult primary tumor, presenting in the operative site of a thoracic meningioma: long-term follow-up: Case report. Journal of Neurosurgery. Spine, 21(4), 628-33. https://doi.org/10.3171/2014.6.SPINE13448
Heary RF, et al. Metastatic Renal Cell Carcinoma, With a Radiographically Occult Primary Tumor, Presenting in the Operative Site of a Thoracic Meningioma: Long-term Follow-up: Case Report. J Neurosurg Spine. 2014;21(4):628-33. PubMed PMID: 25014504.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metastatic renal cell carcinoma, with a radiographically occult primary tumor, presenting in the operative site of a thoracic meningioma: long-term follow-up: Case report. AU - Heary,Robert F, AU - Agarwal,Nitin, AU - Barrese,James C, AU - Barry,Maureen T, AU - Baisre,Ada, Y1 - 2014/07/11/ PY - 2014/7/12/entrez PY - 2014/7/12/pubmed PY - 2014/12/15/medline KW - EMA = epithelial membrane antigen KW - RCC = renal cell carcinoma KW - meningioma KW - metastasis KW - oncology KW - radiographically occult primary tumor KW - renal cell carcinoma KW - thoracic SP - 628 EP - 33 JF - Journal of neurosurgery. Spine JO - J Neurosurg Spine VL - 21 IS - 4 N2 - Lesions metastatic to the site of a meningioma resection from a different primary tumor are rare. Metastasis of a tumor without a known primary tumor is also rare. Metastasis of a renal cell carcinoma, without an identifiable primary tumor, to the bed of a meningioma resection has not been previously reported. The authors describe the case of a 54-year-old man who presented with decreased sensory and motor function in the lower extremities. He underwent T3-5 laminectomies and gross-total removal of an intradural, extramedullary meningioma. The postoperative course was uneventful, and the patient regained full neurological function. After a 3-year period, he developed progressive upper thoracic pain and lower-extremity paresthesias. Imaging studies showed an epidural mass at the T2-4 levels and what appeared to be blastic involvement of the T2-4 vertebrae. A metastatic workup was negative. Emergency revision laminectomies yielded a fibrous, nonvascular mass. Neuropathology was consistent with metastatic renal cell carcinoma. After 6 months, the patient's symptoms of pain and paresthesias recurred. Repeat excision, with decompression of the spinal cord, revealed tumor cells morphologically and immunophenotypically similar to those obtained from the prior surgery. Cytogenetic analysis confirmed the presence of metastatic renal cell carcinoma. A novel case of an epidural metastatic renal cell carcinoma, of unknown primary origin, in the same operative bed of a previously resected intradural, extramedullary meningioma of the thoracic spine is reported. SN - 1547-5646 UR - https://www.unboundmedicine.com/medline/citation/25014504/Metastatic_renal_cell_carcinoma_with_a_radiographically_occult_primary_tumor_presenting_in_the_operative_site_of_a_thoracic_meningioma:_long_term_follow_up:_Case_report_ DB - PRIME DP - Unbound Medicine ER -