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 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.

Informations de copyright

© 2023, The Authors.

Déclaration de conflit d'intérêts

Disclosures Dr. Mummaneni reported personal fees from DePuy Synthes, Globus, NuVasive, Stryker, BK Medical, Brainlab, and SI Bone; book royalties from Thieme Publishing and Springer Publishing; grants from AO Spine, NIH/NIAMS (U19AR076737), PCORI, Pacira, NREF, and ISSG; and stock ownership in Spinicity/ISD, outside the submitted work.Dr. Mummaneni reported personal fees from DePuy Synthes, Globus, NuVasive, Stryker, BK Medical, Brainlab, and SI Bone; book royalties from Thieme Publishing and Springer Publishing; grants from AO Spine, NIH/NIAMS (U19AR076737), PCORI, Pacira, NREF, and ISSG; and stock ownership in Spinicity/ISD, outside the submitted work.