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Washington University Experience | NEOPLASMS (METASTASES) | Meningeal | 3A0 Case 3 History
Case 3 History ---- The patient was a 37 year old man diagnosed in July of 2001 with metastatic renal cell carcinoma. He presented with weight loss and bilateral lower extremity weakness (left > right) with numbness over the lateral thigh and urinary incontinence. He had widespread bone, lung, liver and brain metastatic disease. He received whole brain radiation therapy. He underwent laparoscopic radical nephrectomy with planned Imuran therapy. Pre-operatively, he was described as having poor mental status. An MRI of the brain revealed hydrocephalus (possibly communicating secondary to leptomeningeal carcinomatosis vs. atrophy). A right frontal venous angioma was seen. There were multiple enhancing lesions throughout the brain suggestive of metastatic disease. There was no leptomeningeal enhancement. An MRI of the spine did not reveal cord compression, but an L3 metastasis was seen with nerve impingement and metastases at multiple thoracic and lumbar levels were seen. The patient was found apneic with asystole. He was coded briefly and pronounced dead.
