RT Journal Article
SR Electronic
T1 Renal cell carcinoma metastasis to the cerebellopontine cistern: intraoperative Onyx embolization via direct needle puncture
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr2013010966
DO 10.1136/bcr-2013-010966
VO 2013
A1 Jeremiah Johnson
A1 Jacques Morcos
A1 Mohamed Elhammady
A1 Christine L Pao
A1 Mohammad Ali Aziz-Sultan
YR 2013
UL http://casereports.bmj.com/content/2013/bcr-2013-010966.abstract
AB 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.