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Embolization as treatment for spinal cord compression from renal cell carcinoma: case report
T A Kuether1, G M Nesbit, S L Barnwell
1Division of Neurosurgery, Oregon Health Sciences University, Portland, USA.
Objective And Importance:
Metastatic renal cell carcinoma may involve the vertebrae, resulting in acute spinal cord compression. Embolization has been used to reduce operative blood loss during surgical decompression, but it has not been considered as an alternative that may eliminate the need for open debulking.
Clinical Presentation:
A case is presented of a 30-year-old woman with renal cell carcinoma who developed increasing severe back pain, lower extremity weakness, and sensory loss. Magnetic resonance evaluation revealed a T5 metastasis, resulting in significant spinal cord compression.
Intervention:
Transarterial embolization was performed with polyvinyl alcohol particles and platinum microcoils. One month after embolization, the patient's lower extremity strength and sensation had improved, and magnetic resonance imaging demonstrated a dramatic response with a significant reduction of cord compression. She deteriorated again 4 months later, and a new sacral mass was embolized. She again improved after treatment.
Conclusion:
This report illustrates that embolization may be used as palliative treatment for spinal cord compression and obviate the need for open surgical decompression.