Surgical resection of lumbar intradural metastatic renal cell carcinoma

A 60-year-old male with renal cell carcinoma (RCC) presented with back pain, weakness, and bowel and bladder urgency. MRI demonstrated a cauda equina tumor at L2. Following L1–3 laminectomies, intraoperative ultrasound localized the tumor. After dural opening, a vascular tumor was adherent to the ca...

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Autores principales: Macki, Mohamed, Ambati, Vardhaan S., Park, Christine, Tawil, Michael, Dada, Abraham, Jamieson, Alysha, Wilkinson, Sean, Chryssikos, Timothy, Mummaneni, Praveen V.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Association of Neurological Surgeons 2023
Materias:
Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10583818/
https://www.ncbi.nlm.nih.gov/pubmed/37859942
http://dx.doi.org/10.3171/2023.7.FOCVID2379
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author Macki, Mohamed
Ambati, Vardhaan S.
Park, Christine
Tawil, Michael
Dada, Abraham
Jamieson, Alysha
Wilkinson, Sean
Chryssikos, Timothy
Mummaneni, Praveen V.
author_facet Macki, Mohamed
Ambati, Vardhaan S.
Park, Christine
Tawil, Michael
Dada, Abraham
Jamieson, Alysha
Wilkinson, Sean
Chryssikos, Timothy
Mummaneni, Praveen V.
author_sort Macki, Mohamed
collection PubMed
description A 60-year-old male with renal cell carcinoma (RCC) presented with back pain, weakness, and bowel and bladder urgency. MRI demonstrated a cauda equina tumor at L2. Following L1–3 laminectomies, intraoperative ultrasound localized the tumor. After dural opening, a vascular tumor was adherent to the cauda equina. Intraoperative nerve stimulation helped to identify the nerve rootlets. Tumor was removed in a piecemeal fashion. Tumor dissection caused periodic spasms in L1–3 distributions. A neuromonitoring checklist was used to recover motor evoked potential signals with elevated mean arterial pressures. Hemostasis was challenging with the vascular tumor. Intraoperative ultrasound confirmed tumor debulking. Pathology confirmed metastatic RCC.
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spelling pubmed-105838182023-10-19 Surgical resection of lumbar intradural metastatic renal cell carcinoma Macki, Mohamed Ambati, Vardhaan S. Park, Christine Tawil, Michael Dada, Abraham Jamieson, Alysha Wilkinson, Sean Chryssikos, Timothy Mummaneni, Praveen V. Neurosurg Focus Video Article A 60-year-old male with renal cell carcinoma (RCC) presented with back pain, weakness, and bowel and bladder urgency. MRI demonstrated a cauda equina tumor at L2. Following L1–3 laminectomies, intraoperative ultrasound localized the tumor. After dural opening, a vascular tumor was adherent to the cauda equina. Intraoperative nerve stimulation helped to identify the nerve rootlets. Tumor was removed in a piecemeal fashion. Tumor dissection caused periodic spasms in L1–3 distributions. A neuromonitoring checklist was used to recover motor evoked potential signals with elevated mean arterial pressures. Hemostasis was challenging with the vascular tumor. Intraoperative ultrasound confirmed tumor debulking. Pathology confirmed metastatic RCC. American Association of Neurological Surgeons 2023-10-01 /pmc/articles/PMC10583818/ /pubmed/37859942 http://dx.doi.org/10.3171/2023.7.FOCVID2379 Text en © 2023, The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the CC BY license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Article
Macki, Mohamed
Ambati, Vardhaan S.
Park, Christine
Tawil, Michael
Dada, Abraham
Jamieson, Alysha
Wilkinson, Sean
Chryssikos, Timothy
Mummaneni, Praveen V.
Surgical resection of lumbar intradural metastatic renal cell carcinoma
title Surgical resection of lumbar intradural metastatic renal cell carcinoma
title_full Surgical resection of lumbar intradural metastatic renal cell carcinoma
title_fullStr Surgical resection of lumbar intradural metastatic renal cell carcinoma
title_full_unstemmed Surgical resection of lumbar intradural metastatic renal cell carcinoma
title_short Surgical resection of lumbar intradural metastatic renal cell carcinoma
title_sort surgical resection of lumbar intradural metastatic renal cell carcinoma
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10583818/
https://www.ncbi.nlm.nih.gov/pubmed/37859942
http://dx.doi.org/10.3171/2023.7.FOCVID2379
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