Intramedullary Spinal Metastatic Renal Cell Carcinoma: Systematic Review of Disease Presentation, Treatment, and Prognosis with Case Illustration

Umaru Barrie, Mahmoud Elguindy, Mark Pernik, Emmanuel Adeyemo, Salah G. Aoun, Kristen Hall, Valery Peinado Reyes, Tarek Y. EL Ahmadieh, Carlos A. Bagley

Research output: Contribution to journalReview article

Abstract

Objective: Renal cell carcinoma (RCC) metastases to the intramedullary spinal cord carry a grim prognosis. The purpose of this review is to provide the reader with a comprehensive and systematic review of the current literature, and to present an illustrative case that would aid in the future management of similar scenarios. Methods: A systematic review of the literature using the PubMed electronic database was made according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Only human clinical reports of intramedullary RCC metastasis were included. We also present an illustrative case that was treated at our institution. Results: We identified 23 reports with a total of 31 patients. Of the tumors, 47% were located at the cervical level. Brain metastases were present in 41% of cases. Limb weakness (72%), urinary incontinence (41%), dysesthesia (47%), and localized spinal pain (38%) were the most frequently reported symptoms. Surgical resection alone was used in 34% of cases, followed by a combination of surgery and radiotherapy (31%), and radiotherapy alone (25%). Spinal metastases were detected an average of 32.1 months after the diagnosis of RCC, and mean patient survival after that was 8 months (range, 0–65 months). Reported survival after radiotherapy appeared to be the longest (11.2 months) compared with surgery (9.1 months) and combination therapy (5 months). Conclusions: Intramedullary spinal metastatic RCC is a rare entity with debilitating neurologic potential. Survival appears to be affected by the treatment method but is also likely influenced by the stage of discovery of the disease.

Original languageEnglish (US)
Pages (from-to)584-593
Number of pages10
JournalWorld neurosurgery
Volume134
DOIs
StatePublished - Feb 2020

Keywords

  • Intramedullary metastasis
  • Intramedullary tumor
  • Renal carcinoma survival
  • Renal cell carcinoma
  • Spinal metastasis
  • Systematic review

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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