Intradural spinal metastasis to the cauda equina in renal cell carcinoma: a case report and review of the literature

Spine (Phila Pa 1976). 2009 Nov 15;34(24):E892-5. doi: 10.1097/BRS.0b013e3181b34e6c.

Abstract

Study design: Case description.

Objectives: To describe a case of intradural metastasis from a renal cell carcinoma (RCC) spread to the cauda equina, and review the pertinent medical literature.

Summary of background data: Intradural spinal metastasis is rare, accounting for 6% of all spinal metastases. Only 7 cases of intradural metastasis from a RCC to the cauda equina have been previously reported.

Methods: A 41-year-old male presented with a 1-month history of severe back pain radiating to both legs. The patient underwent a right nephrectomy for treatment of a RCC 1-year before admission. Magnetic resonance imaging showed a well-demarcated, intradural extramedullary mass at the L2 vertebra.

Results: After a total laminectomy, total excision of the tumor was achieved followed by rapid improvement of the back pain. The tumor was histologically verified as metastatic RCC, identical to that of a previous tumor specimen. The patient was asymptomatic on the 1-year follow-up.

Conclusion: Although the majority of cauda equina tumors are primary tumors, intradural metastasis should be considered before surgery in patients with previously treated RCC.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Carcinoma, Renal Cell / secondary*
  • Decompression, Surgical
  • Humans
  • Kidney Neoplasms / pathology*
  • Laminectomy
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / pathology
  • Lumbar Vertebrae / surgery
  • Magnetic Resonance Imaging
  • Male
  • Polyradiculopathy / etiology*
  • Polyradiculopathy / pathology*
  • Polyradiculopathy / physiopathology
  • Radiography
  • Sciatica / etiology
  • Spinal Cord Neoplasms / secondary*
  • Spinal Nerve Roots / diagnostic imaging
  • Spinal Nerve Roots / pathology
  • Spinal Nerve Roots / surgery
  • Subarachnoid Space / diagnostic imaging
  • Subarachnoid Space / pathology
  • Subarachnoid Space / surgery
  • Treatment Outcome