神経鞘腫に類似した転移性馬尾腫瘍の 1 例

概要

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The authors report a rare case of renal cell carcinoma with metastasis to the cauda equina. A 68-year old male was evaluated for a two-year history of increasing low back pain. His medical history included a renal cell carcinoma diagnosed seven years earlier and treated by right nephrectomy. He then underwent partial pneumonectomies on three occasions for metastatic lung tumors from the primary lesion. On admission, he showed radicular pain projecting into the right L5 region, but he exhibited no sensorimotor deficits. Lumbosacral MR imaging revealed an intradural extramedullary mass at the level of L3. He underwent L2-4 laminectomy. The tumor had not infiltrated into the subarachnoid space and involved only one spinal nerve that was excised during surgery. The tumor was removed successfully and was confirmed by the pathology to be a metastasis from a renal cell carcinoma. His postoperative course was satisfactory. He noticed relief from radicular pain and left hospital on the twelfth postoperative day without neurological deficits. The majority of cauda equina tumors are primary tumors, and metastases from outside of the central nerves system are extremely rare. To our knowledge, only a few cases have been reported in detail in the literature. The literature is reviewed with reference to tumor pathology, diagnostic future and modes of metastasis to the cauda equina.
日本脊髄外科学会の論文
2002-07-31