The occult nature of intramedullary spinal cord metastases from renal cell carcinoma

Abstract

Renal cell carcinomas (RCC) are characterised by a tendency to metastasise widely, often while remaining occult. Intramedullary spinal cord metastases (ISCM) from RCC may be the presenting feature of the disease or present at any time in the disease course. This case report discusses an ISCM from RCC which became manifested at the time of resection of the primary tumour. We review the literature published on ISCM from RCC from 1990 to date comparing disease characteristics and presentations.

Figure 1

(A) T1-weighted sagittal MRI with gadolinium showing an intramedullary mass lesion at the C7 level. (B) T₁-weighted axial MRI with gadolinium showing an intramedullary mass lesion at the C7 level. (C) Photomicrograph showing metastatic renal cell carcinoma (RCC) A. Prominent delicate capillary-like vessels showing clusters of epithelial cells with clear cytoplasm. H&E ×100 B.(D) Photomicrograph showing metastatic carcinoma. CD10 immunohistochemistry showing positive labelling (brown signal) of cytoplasm and cell membranes in keeping with RCC (clear cell type). CD10 immunostain ×200.