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Entero-paraspinous fistula from recurrent spinal metastatic renal cell carcinoma
Journal article   Open access   Peer reviewed

Entero-paraspinous fistula from recurrent spinal metastatic renal cell carcinoma

Ambur Reddy, Patrick W Hitchon, Sami Al-Nafi and Kent Choi
Journal of neurosurgery. Spine, Vol.22(1), pp.60-63
01/2015
DOI: 10.3171/2014.10.SPINE14294
PMID: 25396260
url
https://doi.org/10.3171/2014.10.SPINE14294View
Published (Version of record) Open Access

Abstract

The authors report a case of entero-paraspinous fistula 2 years after T-12 corpectomy and instrumentation for spinal metastasis from renal cell carcinoma. The pathogenesis in the present case seems to have arisen from local recurrence of T-12 metastatic carcinoma in spite of radiation and corpectomy. As a result of previous nephrectomy and anterolateral dissection for the T-12 corpectomy, the jejunum adhered to the surgical site. Recurrent tumor at T-12 invaded the adherent small bowel loop, resulting in a fistulous communication between the small bowel lumen and the spinal wound. Loss of retroperitoneal fat, scarring, and adhesions from previous surgeries contributed to this complication by having the jejunum close to the T-12 corpectomy site, and eventually to its invasion by recurrent tumor. Avoidance of such a complication is difficult; however, total excision of the spinal malignancy, and when possible, creating a barrier cuff of fascia or fat around the spine to protect abdominal contents, are potential solutions.
Thoracic Vertebrae - diagnostic imaging Jejunum - surgery Carcinoma, Renal Cell - diagnostic imaging Fistula - diagnostic imaging Humans Carcinoma, Renal Cell - surgery Male Tomography, X-Ray Computed Neoplasm Recurrence, Local - surgery Decompression, Surgical Kidney Neoplasms - surgery Thoracic Vertebrae - surgery Neoplasm Recurrence, Local - diagnostic imaging Nephrectomy Carcinoma, Renal Cell - secondary Fatal Outcome Kidney Neoplasms - pathology Aged Jejunum - diagnostic imaging

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