Preoperative stereotactic body radiotherapy to a skull renal cell metastasis: an alternative to preoperative embolization?

Abstract

This is the first case study to report on using stereotactic body radiotherapy as an alternative and novel treatment modality for embolization to reduce the risk of operative bleeding for a metastatic renal cell tumor. A 58-year-old woman presented with an asymptomatic large 7-cm tumor on the parieto-occipital vertex of the skull. Given the location of this lesion along with its vascular histology, it was a challenge to provide safe and effective treatment using conventional management strategies. We report on a rare presentation of a metastatic renal cell cancer and the use of stereotactic body radiotherapy as an innovative radiation approach to deliver high-dose radiation safely to control this large aggressive and vascular metastasis. The success of this management strategy allowed for minimal intraoperative blood loss, and the patient continues with local control 1-year posttreatment.