Renal carcinoma metastasis: an unusual cerebellopontine angle tumor

Metastatic Renal Cell Carcinoma Mimicking Trigeminal Schwannoma in a Patient Presenting with Trigeminal Neuralgia

We present an unusual case of a metastatic renal cell carcinoma (RCC) mimicking trigeminal schwannoma. The patient, with no prior history of RCC, presented with clinical symptoms and imaging consistent with trigeminal neuralgia secondary to trigeminal schwannoma. Magnetic resonance imaging of the brain showed a large bilobed cystic/solid mass primarily in the cerebellopontine angle cistern, with extension into the left middle cranial fossa, Meckel cave, and left cavernous sinus. Following surgical excision, histopathology revealed the tumor to be an RCC infiltrating into the trigeminal nerve fascicles. Further imaging and investigation revealed widespread metastasis to the vertebral bodies and long bones. Metastatic RCC to the trigeminal nerve is rare. Despite the development of more effective treatment modalities, the prognosis of metastatic RCC remains poor. To our knowledge, this is the first reported case of RCC metastasizing to the trigeminal nerve fascicles.

Renal cell carcinoma metastasis to the cerebellopontine cistern: intraoperative Onyx embolization via direct needle puncture

We report a rare case of a renal cell carcinoma (RCC) metastasis occupying the cerebellopontine and cerebellomedullary cisterns, and describe an alternative strategy for embolizing hypervascular intracranial tumors. A middle aged patient with a distant history of RCC presented with headaches, nausea, and vomiting, and was found to have an enhancing mass in the left cerebellopontine and cerebellopontine cisterns. The initial surgical resection was aborted due to excessive bleeding. After an unsuccessful attempt at intra-arterial embolization, the patient returned to the operating room and the tumor was devascularized by direct needle puncture Onyx embolization under biplane fluoroscopy. The devascularized tumor was then successfully dissected from the brainstem and adherent lower cranial nerves. In properly selected cases, open surgical direct needle puncture embolization of intracranial vascular tumors under biplane fluoroscopy is a viable alternative devascularization method.

Renal cell carcinoma metastasis to the cerebellopontine cistern: intraoperative Onyx embolization via direct needle puncture

We report a rare case of a renal cell carcinoma (RCC) metastasis occupying the cerebellopontine and cerebellomedullary cisterns, and describe an alternative strategy for embolizing hypervascular intracranial tumors. A middle aged patient with a distant history of RCC presented with headaches, nausea, and vomiting, and was found to have an enhancing mass in the left cerebellopontine and cerebellopontine cisterns. The initial surgical resection was aborted due to excessive bleeding. After an unsuccessful attempt at intra-arterial embolization, the patient returned to the operating room and the tumor was devascularized by direct needle puncture Onyx embolization under biplane fluoroscopy. The devascularized tumor was then successfully dissected from the brainstem and adherent lower cranial nerves. In properly selected cases, open surgical direct needle puncture embolization of intracranial vascular tumors under biplane fluoroscopy is a viable alternative devascularization method.

Bilateral internal acoustic canal mass

We reported a case of bilateral internal acoustic canal mass. A 42-year-old man patient was previously treated for colon cancer. After surgery during chemotherapy signs as severe vertigo and bilateral sudden hearing loss occurred. Temporal bone magnetic resonance imaging (MRI) had bilateral internal acoustic canal masses.

Metastatic tumours mimicking vestibular schwannoma

In this review of the literature we discuss the rare occurrence of metastatic tumours mimicking bilateral vestibular schwannoma and present an own case with pancreatic signet-ring cell carcinoma as primary tumour.

Asymptomatic cerebellopontine angle and lateral ventricle metastases from renal cell carcinoma: case report and literature review

Tumors rarely metastasize to the cerebellopontine angle. We report the first instance of simultaneous metastasis of renal cell carcinoma to the cerebellopontine angle and the lateral ventricle. A 51-year-old man presented with anemia and fatigue owing to stomach metastases from renal cell carcinoma 8 years after undergoing partial left nephrectomy for grade II clear cell renal carcinoma and radical right nephrectomy for grade III clear cell renal carcinoma. He also suffered metastases to the lung, both adrenal glands, the L-3 vertebra, and the brain (asymptomatic, but revealed by magnetic resonance imaging): a 1-cm (maximum diameter) mass in the left medullary cistern and a 2-cm (maximum diameter) mass in the right lateral ventricle trigone. Both brain lesions were treated with stereotactic radiosurgery, followed by gross-total resection of the right trigonal mass 7 months later. Both tumors shrank significantly, but the patient died from progressive systemic cancer 1 year after diagnosis of brain metastasis.

Vanishing tumour of the internal auditory meatus

OBJECTIVES

We report a very rare case of prostatic metastasis in the internal auditory meatus, which disappeared with treatment.

CASE REPORT

An elderly man presented with a history of hearing loss, dizzy spells and, more recently, facial palsy. He also complained simultaneously of urological symptoms, which on investigation revealed advanced, metastatic prostate cancer. Radiological investigation, in the form of magnetic resonance imaging, revealed an internal auditory meatus mass which resembled an acoustic neuroma. The patient was treated with hormone injections.Tumours of the internal auditory meatus and cerebellopontine angle are mostly primary. Rarely, metastatic deposits have been described in this region, from squamous cell carcinoma, malignant melanoma, malignant parotid oncocytoma, renal carcinoma, and lung and thyroid primaries.

CONCLUSION

To our knowledge, this is a very rare report in the world literature of prostatic metastasis to the internal auditory meatus. We discuss the common presenting features, investigations and treatment options for metastatic prostatic tumours of the internal auditory meatus and cerebellopontine angle.

Endoneural metastasis of the sciatic nerve disclosing the relapse of a renal carcinoma, four years after its surgical treatment

METHODS

To report on an exceptional case of renal metastasis. Indeed, endoneural metastases of peripheral nerves are thought to be exceptional, and such an event has not yet been ascribed to a renal carcinoma.

RESULTS

We report on a sciatica leading to the discovery of a tumour of the right thigh which proved to be an endoneural metastasis of the sciatic nerve from a renal carcinoma surgically removed 4 years before.

CONCLUSION

A thorough palpation of peripheral nerve can help recognise such metastases in patients previously diagnosed with renal carcinoma.