[Metastatic renal cell carcinoma initially presented with a longitudinally extensive spinal cord lesion on MRI]

Rinsho Shinkeigaku. 2016 May 31;56(5):348-51. doi: 10.5692/clinicalneurol.cn-000850. Epub 2016 Apr 19.
[Article in Japanese]

Abstract

A 48-year old male patient developed numbness in the lower half of the body 5 months after the curative operation of left renal cell carcinoma. Neurological examinations revealed the sensory disturbance below the T10 dermatome. A sagittal T2WI of the spinal MRI demonstrated a longitudinally extensive spinal cord lesion (LESCL) ranging from the C7 to L1 vertebral level. The neurological deficits rapidly deteriorated to paraplegia with bladder bowel disturbance. The high dose steroid pulse therapy showed temporary effect. The Gd enhanced T1WI of the spinal MRI taken on the 24th hospital day demonstrated a solitary intramedullary mass in the T8-9 level with ring enhancement, and a subsequent total resection of the tumor was performed. The histopathological studies of the tumor lead to the diagnosis of intramedullary spinal cord metastasis of the renal cell carcinoma. The post-operative T2WI of the spinal MRI revealed disappearance of the longitudinally extensive lesion. On the 112 hospital day, he was discharged with ambulatory aid. While solitary intramedullary spinal cord metastasis of renal cell carcinoma is quite rare, it should be suspected when the LESCL is revealed on a spinal MRI, even after the curative operation of the primary tumor.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Renal Cell / diagnostic imaging*
  • Carcinoma, Renal Cell / pathology
  • Carcinoma, Renal Cell / secondary*
  • Carcinoma, Renal Cell / surgery
  • Cervical Vertebrae
  • Diffusion Magnetic Resonance Imaging*
  • Humans
  • Kidney Neoplasms / pathology*
  • Male
  • Middle Aged
  • Spinal Cord / diagnostic imaging*
  • Spinal Cord / pathology
  • Spinal Cord Neoplasms / diagnostic imaging*
  • Spinal Cord Neoplasms / pathology
  • Spinal Cord Neoplasms / secondary*
  • Spinal Cord Neoplasms / surgery
  • Thoracic Vertebrae