Surgical resection of lumbar intradural metastatic renal cell carcinoma.

Mohamed Macki, Vardhaan S Ambati, Christine Park, Michael Tawil, Abraham Dada, Alysha Jamieson, Sean Wilkinson, Timothy Chryssikos, Praveen V Mummaneni
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引用次数: 0

Abstract

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.

腰椎硬膜下转移性肾细胞癌的手术切除。
一名60岁男性肾细胞癌(RCC)患者表现为背痛、虚弱、排便和膀胱紧迫。MRI显示L2处有马尾肿瘤。L1-3椎板切除术后,术中超声定位肿瘤。硬膜切开后,马尾神经上附着着一个血管肿瘤。术中神经刺激有助于识别神经根。肿瘤是以零碎的方式切除的。肿瘤剥离引起L1-3分布的周期性痉挛。神经监测检查表用于恢复平均动脉压升高的运动诱发电位信号。血管肿瘤的止血具有挑战性。术中超声检查证实肿瘤缩小。病理证实转移性RCC。
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