Intradural Extramedullary Spinal Metastasis of a Kidney Cancer: Case Report

 

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Abstract

Objective To report a case of intradural extramedullary metastasis originated from a kidney neoplasm. Metastases in this topography occur in a low frequency, especially considering that the primary tumor was located along the urinary system.

Case Report A male adult begins to present with pain in the lower limbs and develops flaccid paraparesis of the pelvic limbs, also attacking the control of the sphincter. The patient had a previous history of right nephrectomy due to a kidney neoplasm. After investigation with imaging exams, a metastatic lesion was found to be the source of the symptoms. The patient was surgically treated by the neurosurgery team of the hospital.

Conclusion Cases like this are not common, and considering the low incidence of these cases and the nonspecific symptoms, such as pain, we do not always come up with the hypothesis of a metastasis in this topography. The surgical treatment, although it is a palliative feature, has an important part in maintaining the performance and the quality of life of the patient.

Resumo

Objetivo Relatar um caso de metástase intradural extramedular de um carcinoma renal. Metástases nesta topografia são de baixa ocorrência, ainda mais tratando-se de um tumor primário no sistema urinário.

Relato de caso Paciente adulto do sexo masculino que inicia quadro de dor nos membros inferiores, evoluindo com paraparesia crural, tem piora do quadro, acometendo a função esfincteriana. O paciente possuía um histórico prévio de nefrectomia por neoplasia maligna em sítio renal. Após investigação com exames complementares, foi detectada a lesão metastática responsável pelos sintomas. A mesma foi tratada cirurgicamente pela equipe de neurocirurgia do serviço.

Conclusão Casos como este não são comuns e nem sempre nos levam a aventar a hipótese de metástase nesta topografia, frente à baixa incidência e ao início de sintomas muitas vezes inespecíficos, como dor. O tratamento, apesar de paliativo, tem um papel importante na qualidade de sobrevida do paciente.

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