Skip to main content
Top
Published in: Acta Neurochirurgica 7/2009

01-07-2009 | Short Illustrated Review

Intradural spinal metastasis of renal cell cancer. Report of a case and review of 26 published cases

Authors: Gregory Jost, Stephan Zimmerer, Stephan Frank, Dominik Cordier, Adrian Merlo

Published in: Acta Neurochirurgica | Issue 7/2009

Login to get access

Abstract

Metastatic disease in the intradural compartment of the spine is a rare manifestation of cancer. We report the case of an 82-year-old patient with an intradural, extramedullary metastasis of renal cell carcinoma in the cervical spine. A literature search for intradural spinal metastases of renal cell carcinoma yielded a total of 26 further cases. 18 patients had sporadic renal cell carcinoma, and 9 patients had von Hippel-Lindau disease (VHL) in which the metastases of the renal cell carcinoma were embedded within spinal haemangioblastomas. Patients presented with paresis, back pain, altered sensation or, less frequently, bladder dysfunction. Intradural spinal metastases were diagnosed at an earlier age in VHL patients than in sporadic cases (mean 43 ± 5 years vs. 60 ± 14.5 years). The metastasis was surgically removed in 81% of patients. Pain improved in all patients, paresis in 90%, hypaesthesia in 38% and bladder dysfunction in 50%. Death occured as a result of systemic cancer progression. 93% of patients in the sporadic renal cell cancer group died within 1.5 years, whereas two thirds of the VHL patients were alive after 2 years.
Literature
1.
go back to reference Abou-Hamden A, Koszyca B, Carney PG, Sandhu N, Blumbergs PC (2003) Metastasis of renal cell carcinoma to haemangioblastoma of the spinal cord in von Hippel-Lindau disease: case report and review of the literature. Pathology 35:224–227. doi:10.1080/003130203100023191 PubMedCrossRef Abou-Hamden A, Koszyca B, Carney PG, Sandhu N, Blumbergs PC (2003) Metastasis of renal cell carcinoma to haemangioblastoma of the spinal cord in von Hippel-Lindau disease: case report and review of the literature. Pathology 35:224–227. doi:10.​1080/​0031302031000231​91 PubMedCrossRef
4.
go back to reference Altinoz MA, Santaguida C, Guiot MC, Del Maestro RF (2005) Spinal haemangioblastoma containing metastatic renal cell carcinoma in von Hippel-Lindau disease. Case report and review of the literature. J Neurosurg Spine 3:495–500PubMedCrossRef Altinoz MA, Santaguida C, Guiot MC, Del Maestro RF (2005) Spinal haemangioblastoma containing metastatic renal cell carcinoma in von Hippel-Lindau disease. Case report and review of the literature. J Neurosurg Spine 3:495–500PubMedCrossRef
6.
go back to reference Batson OV (1957) The vertebral vein system. Caldwell lecture, 1956. Am J Roentgenol Radium Ther Nucl Med 78:195–212PubMed Batson OV (1957) The vertebral vein system. Caldwell lecture, 1956. Am J Roentgenol Radium Ther Nucl Med 78:195–212PubMed
7.
go back to reference Batson OV (1995) The function of the vertebral veins and their role in the spread of metastases. 1940. Clin Orthop Relat Res 4–9 Batson OV (1995) The function of the vertebral veins and their role in the spread of metastases. 1940. Clin Orthop Relat Res 4–9
10.
go back to reference Couillard DR, deVere White RW (1993) Surgery of renal cell carcinoma. Urol Clin North Am 20:263–275PubMed Couillard DR, deVere White RW (1993) Surgery of renal cell carcinoma. Urol Clin North Am 20:263–275PubMed
15.
go back to reference Gaetani P, Di Ieva A, Colombo P, Tancioni F, Aimar E, Debernardi A, Rodriguez YBR (2004) Intradural spinal metastasis of renal clear cell carcinoma causing cauda equina syndrome. Acta Neurochir (Wien) 146:857–861. doi:10.1007/s00701-004-0299-z CrossRef Gaetani P, Di Ieva A, Colombo P, Tancioni F, Aimar E, Debernardi A, Rodriguez YBR (2004) Intradural spinal metastasis of renal clear cell carcinoma causing cauda equina syndrome. Acta Neurochir (Wien) 146:857–861. doi:10.​1007/​s00701-004-0299-z CrossRef
16.
go back to reference Gomez de la Riva A, Isla A, Perez-Lopez C, Budke M, Gutierrez M, Frutos R (2005) Metastasis intramedular como primera manifestacion de un carcinoma renal. Neurocirugia 16:359–364PubMed Gomez de la Riva A, Isla A, Perez-Lopez C, Budke M, Gutierrez M, Frutos R (2005) Metastasis intramedular como primera manifestacion de un carcinoma renal. Neurocirugia 16:359–364PubMed
18.
go back to reference Guarantors of Brain (2000) Aids to the examination of the peripheral nervous system. Churchill Livingstone, Edinburgh Guarantors of Brain (2000) Aids to the examination of the peripheral nervous system. Churchill Livingstone, Edinburgh
21.
go back to reference Kalayci M, Cagavi F, Gul S, Yenidunya S, Acikgoz B (2004) Intramedullary spinal cord metastases: diagnosis and treatment - an illustrated review. Acta Neurochir (Wien) 146:1347–1354. doi:10.1007/s00701-004-0386-1 discussion 54CrossRef Kalayci M, Cagavi F, Gul S, Yenidunya S, Acikgoz B (2004) Intramedullary spinal cord metastases: diagnosis and treatment - an illustrated review. Acta Neurochir (Wien) 146:1347–1354. doi:10.​1007/​s00701-004-0386-1 discussion 54CrossRef
23.
go back to reference Kaya RA, Dalkilic T, Ozer F, Aydin Y (2003) Intramedullary spinal cord metastasis: a rare and devastating complication of cancer- two case reports. Neurol Med Chir (Tokyo) 43:612–615. doi:10.2176/nmc.43.612 CrossRef Kaya RA, Dalkilic T, Ozer F, Aydin Y (2003) Intramedullary spinal cord metastasis: a rare and devastating complication of cancer- two case reports. Neurol Med Chir (Tokyo) 43:612–615. doi:10.​2176/​nmc.​43.​612 CrossRef
25.
go back to reference Lasjaunias PL, Berenstein A (1987) Surgical Neuro-angiography. Springer-Verlag, Berlin, Germany Lasjaunias PL, Berenstein A (1987) Surgical Neuro-angiography. Springer-Verlag, Berlin, Germany
28.
go back to reference Mak KH, Kwok JC (2001) Intradural spinal metastasis from renal cell carcinoma: a case report. J Orthop Surg (Hong Kong) 9:57–61 Mak KH, Kwok JC (2001) Intradural spinal metastasis from renal cell carcinoma: a case report. J Orthop Surg (Hong Kong) 9:57–61
29.
go back to reference Maxwell M, Borges LF, Zervas NT (1999) Renal cell carcinoma: a rare source of cauda equina metastasis. Case report. J Neurosurg 90:129–132PubMed Maxwell M, Borges LF, Zervas NT (1999) Renal cell carcinoma: a rare source of cauda equina metastasis. Case report. J Neurosurg 90:129–132PubMed
31.
go back to reference Nishijima Y, Koiso K, Nemoto R (1995) The role of the vertebral veins in the dissemination of prostate carcinoma. Nippon Hinyokika Gakkai Zasshi 86:927–932PubMed Nishijima Y, Koiso K, Nemoto R (1995) The role of the vertebral veins in the dissemination of prostate carcinoma. Nippon Hinyokika Gakkai Zasshi 86:927–932PubMed
32.
go back to reference Pagano S, Franzoso F, Ruggeri P (1996) Renal cell carcinoma metastases. Review of unusual clinical metastases, metastatic modes and patterns and comparison between clinical and autopsy metastatic series. Scand J Urol Nephrol 30:165–172PubMedCrossRef Pagano S, Franzoso F, Ruggeri P (1996) Renal cell carcinoma metastases. Review of unusual clinical metastases, metastatic modes and patterns and comparison between clinical and autopsy metastatic series. Scand J Urol Nephrol 30:165–172PubMedCrossRef
34.
go back to reference Polydorides AD, Rosenblum MK, Edgar MA (2007) Metastatic renal cell carcinoma to haemangioblastoma in von Hippel-Lindau disease. Arch Pathol Lab Med 131:641–645PubMed Polydorides AD, Rosenblum MK, Edgar MA (2007) Metastatic renal cell carcinoma to haemangioblastoma in von Hippel-Lindau disease. Arch Pathol Lab Med 131:641–645PubMed
35.
go back to reference Ritchie AW, deKernion JB (1987) The natural history and clinical features of renal carcinoma. Semin Nephrol 7:131–139PubMed Ritchie AW, deKernion JB (1987) The natural history and clinical features of renal carcinoma. Semin Nephrol 7:131–139PubMed
36.
go back to reference Robson CJ, Churchill BM, Anderson W (1969) The results of radical nephrectomy for renal cell carcinoma. J Urol 101:297–301PubMed Robson CJ, Churchill BM, Anderson W (1969) The results of radical nephrectomy for renal cell carcinoma. J Urol 101:297–301PubMed
37.
go back to reference Ryan MW, Rassekh CH, Chaljub G (1996) Metastatic breast carcinoma presenting as cavernous sinus syndrome. Ann Otol Rhinol Laryngol 105:666–668PubMed Ryan MW, Rassekh CH, Chaljub G (1996) Metastatic breast carcinoma presenting as cavernous sinus syndrome. Ann Otol Rhinol Laryngol 105:666–668PubMed
38.
go back to reference Schiff D, O’Neill BP (1996) Intramedullary spinal cord metastases: clinical features and treatment outcome. Neurology 47:906–912PubMed Schiff D, O’Neill BP (1996) Intramedullary spinal cord metastases: clinical features and treatment outcome. Neurology 47:906–912PubMed
39.
go back to reference Schijns OE, Kurt E, Wessels P, Luijckx GJ, Beuls EA (2000) Intramedullary spinal cord metastasis as a first manifestation of a renal cell carcinoma: report of a case and review of the literature. Clin Neurol Neurosurg 102:249–254. doi:10.1016/S0303-8467(00)00106-2 PubMedCrossRef Schijns OE, Kurt E, Wessels P, Luijckx GJ, Beuls EA (2000) Intramedullary spinal cord metastasis as a first manifestation of a renal cell carcinoma: report of a case and review of the literature. Clin Neurol Neurosurg 102:249–254. doi:10.​1016/​S0303-8467(00)00106-2 PubMedCrossRef
40.
go back to reference Shuin T, Yamasaki I, Tamura K, Okuda H, Furihata M, Ashida S (2006) Von Hippel-Lindau disease: molecular pathological basis, clinical criteria, genetic testing, clinical features of tumours and treatment. Jpn J Clin Oncol 36:337–343. doi:10.1093/jjco/hyl052 PubMedCrossRef Shuin T, Yamasaki I, Tamura K, Okuda H, Furihata M, Ashida S (2006) Von Hippel-Lindau disease: molecular pathological basis, clinical criteria, genetic testing, clinical features of tumours and treatment. Jpn J Clin Oncol 36:337–343. doi:10.​1093/​jjco/​hyl052 PubMedCrossRef
42.
go back to reference Takahashi I, Isu T, Iwasaki Y, Akino M, Takahashi A, Abe H, Kitagawa M, Kojima H, Inoue K, Saitoh H (1990) Metastatic Grawitz tumour to the cauda equina: case report. No Shinkei Geka 18:1157–1160PubMed Takahashi I, Isu T, Iwasaki Y, Akino M, Takahashi A, Abe H, Kitagawa M, Kojima H, Inoue K, Saitoh H (1990) Metastatic Grawitz tumour to the cauda equina: case report. No Shinkei Geka 18:1157–1160PubMed
43.
go back to reference Tobinick E, Vega CP (2006) The cerebrospinal venous system: anatomy, physiology, and clinical implications. Med Gen Med 8:53 Tobinick E, Vega CP (2006) The cerebrospinal venous system: anatomy, physiology, and clinical implications. Med Gen Med 8:53
45.
go back to reference Weiss L, Harlos JP, Torhorst J, Gunthard B, Hartveit F, Svendsen E, Huang WL, Grundmann E, Eder M, Zwicknagl M et al (1988) Metastatic patterns of renal carcinoma: an analysis of 687 necropsies. J Cancer Res Clin Oncol 114:605–612. doi:10.1007/BF00398185 PubMedCrossRef Weiss L, Harlos JP, Torhorst J, Gunthard B, Hartveit F, Svendsen E, Huang WL, Grundmann E, Eder M, Zwicknagl M et al (1988) Metastatic patterns of renal carcinoma: an analysis of 687 necropsies. J Cancer Res Clin Oncol 114:605–612. doi:10.​1007/​BF00398185 PubMedCrossRef
Metadata
Title
Intradural spinal metastasis of renal cell cancer. Report of a case and review of 26 published cases
Authors
Gregory Jost
Stephan Zimmerer
Stephan Frank
Dominik Cordier
Adrian Merlo
Publication date
01-07-2009
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 7/2009
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-009-0358-6

Other articles of this Issue 7/2009

Acta Neurochirurgica 7/2009 Go to the issue