Metastatic renal cell carcinoma initially presented with an intramedullary spinal cord lesion: a case report

Abstract

IntroductionOne of the rare manifestations of systemic neoplasia is intramedullary spinal cord metastasis that causes serious diagnostic and therapeutic dilemma. It has been very rarely reported as the initial manifestation of carcinoma. This is report of a metastatic renal cell carcinoma initially presented with intramedullary spinal cord lesion, to our knowledge there are few similar reports in literature.Case presentationWe report a 51-year-old Iranian woman who presented with back pain and paraparesis. MR imaging study of her spine showed an enhancing cystic lesion at the level of conus medullaris. Despite detailed investigation, no specific aetiology was found till a bone scan obtained to evaluate an agonizing pain on the dorsum of the left hand revealed photon deficient area within the left kidney in addition to oseoblastic bony lesions. After thorough imaging investigation she underwent radical nephrectomy which confirmed renal cell carcinoma.ConclusionConsidering the prevalence of cancer, it is imperative that clinicians be mindful of occult carcinoma as the cause of suspicious intramedullary spinal cord lesion.

Hippocampal synaptic and neural network deficits in young mice carrying the human APOE4 gene

“… in which there were no significant alterations in hippocampal dendritic spine density between 1‐, 3‐ and 12‐month‐old Apoe4 mice using Golgi staining. The difference in findings may be explained by the variation in experimental approach as Golgi staining tends to underestimate spine density . Using Imaris reconstruction following confocal Z‐stack, we were able to quantify accurately the dendritic spines on the Z plane, which is not possible in the Golgi‐stained sections.…”

Intramedullary Spinal Cord Metastasis of Bladder Carcinoma: A Case Report

“…Providing successful palliation and improving patients' quality of life requires multidisciplinary strategic treatment planning [6]. Our patient's treatment started with corticotherapy, and then he underwent surgery.…”

“…determined in their case report and literature review that surgery provides improvement in neurological status and survival in patients with ISCM [14]. Due to improvements of surgical techniques, many patients might have benefit from more effective surgical treatment modalities such as radical, open excision, minimally invasive surgery like endoscopy to ultraminimal/ noninvasive spinal radiosurgery [6].…”

“…One to 3.4 percent of spinal cord lesions are metastatic [1][2][3][4]. Most of the intramedullary metastases occur primarily from lung cancer while the others originate from breast cancer, malign melanoma, ovarian tumour, Hodgkin's disease, colorectal carcinoma, thyroid carcinoma and renal cell carcinoma [1,3,[5][6][7][8][9][10][11]. There is a long list of primary tumours that metastasize to the spinal cord, but ISCM of bladder cancer is documented in only two case reports [3,12].…”

Clinical Spectrum of Patients with Renal Cell Carcinoma

“…Back pain and sciatica due to metastatic nerve root infiltration of lumbo sacral nerves have been reported in RCC patients (Shakeel et al, 2009). Intramedullary spinal metastasis that are the rarest type of spinal involvement have also been reported as the presenting sign in RCC (Asadi et al, 2009;Donovan& Freeman, 2006;Gómez de la Riva et al, 2005;Schijns et al, 2000). Although uncommon, an occult cancer such as renal cell carcinoma needs to be considered in differential diagnosis of the above-mentioned syndromes.…”