Vertebral metastasis (RCC)
Lower limb weakness and back pain.
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MRI of the thoracolumbar spine demonstrates a very large expansile mass replacing most of the T10 vertebral body and resulting in compression of the cord with some increased cord T2 signal.
Renal cell carcinoma metastasis (this patient had a known history of RCC, and this mass was subsequently operated upon and the diagnosis confirmed) are well known to result in expansile bony metastases. In addition, these lesions are usually very vascular, and if the diagnosis is suspected preoperatively, embolisation is often helpful in reducing intraoperative blood loss.