Presentation
Complaints of pain and limited mobility in the cervical spine. The x-ray of the cervical spine was taken.
Patient Data
No bone destruction is detected.
After 2.5 months due to a sharp increase in the presenting complaint, CT of the cervical spine was requested.
Large soft tissue mass, leading to the destruction of more than 50% of the volume of C2-C3 vertebrae, mainly on the right side. The soft-tissue mass spreads to the right parts of the spinal canal, pushing aside and compressing the dural sac.
CT angiography was requested to assess the vertebral artery, the boundaries and the possible source of blood supply to a tumor. A large mass with clear contours is determined, with the presence of an extensive pathological vascular network supplied by the branches of a. cervicalis profunda and a. cervicalis ascendens on both sides. Venous outflow is probably via vv. cervicalis profundae.
CT scan of the abdomen in the delayed phase after angiography revealed a large tumor of the right kidney with signs of pathological vascular venous mets along the upper pole with probable soft tissue focus of bony destruction in the body of the right ilium.
The remaining bones at the studied levels are without destructive changes. There are no visible liver metastases. CT scan of the lungs without focal changes (not shown).
The branches of a. cervicalis profunda and a. cervicalis ascendens on both sides.
Case Discussion
The patient was referred to a specialized neurosurgery center for biopsy and surgical treatment. The histology results are unfortunately not known. The probable diagnosis - renal cell carcinoma with bone metastases.
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