Surgical treatment options and management strategies of metastatic renal cell carcinoma to the lumbar spinal nerve roots.
Spinal nerve root metastasis of renal cell carcinoma is a rare occurrence. In addition to treatment of the primary lesion, surgical resection of the nerve root metastasis, occasionally with sacrifice of the involved nerve, is the accepted standard of treatment. Resection often resolves presenting motor and pain symptoms due to relief of neural compression. We describe two patients with nerve root metastasis of renal cell carcinoma and their management. While locally advanced and metastatic renal cell carcinoma has been shown to be chemo- and radio-resistant, immunotherapy is a promising treatment. Given the high prevalence of systemic disease in patients with intradural metastases, systemic (and possibly intracranial) imaging can be used to identify other potential areas of disease.
Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02115, USA.
Christian
C
Strong
Vijay
V
Yanamadala
Arjun
A
Khanna
Brian P
BP
Walcott
Brian V
BV
Nahed
Lawrence F
LF
Borges
Jean-Valery C E
JV
Coumans
D000368:Aged; D002292:Carcinoma, Renal Cell / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D010524:Peripheral Nervous System Neoplasms / Q000556:secondary* / Q000601:surgery*; D013126:Spinal Nerve Roots / Q000473:pathology / Q000601:surgery
Cauda equina; Intradural; Metastasis; Nerve root; Renal; Spine