Metastatic renal cell carcinoma with cord compression

Case contributed by Dr Ian Bickle


Back pain, bilateral leg weakness.

Patient Data

Age: 70 years
Gender: Male

Multiple T2 hyperintense, T1 hypointense lesions throughout the spine, including the sacrum.

Enhancing destructive lesions in the bodies of T8, T9 and T10 extending into the right pedicles and laminae with intradural extension, causing cord compression. Additional soft-tissue extension into the paravertebral muscles at these levels.

4 cm mass in the lower pole of the left kidney.

Case Discussion

Skeletal metastases are common and MRI is frequently performed to assess for cord compression.

Renal cell carcinoma is one of the typical primaries, along with lung, breast and prostate, to metastasize to the spine.

HISTOLOGY: Excision biopsy from thoracic spine: Metastatic renal cell carcinoma.

The axial upper abdomen views here were performed in this case after identifying the mass on the localizers. The alert radiographer and radiologist should review the localizer images of studies as they may reveal additional information pertinent to the diagnostic process.

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