Published in:
01-10-2007 | Image of the month
Diagnosis of endoneural sciatic nerve invasion by uterine cervical epidermoid cancer using [18F]FDG-PET/CT
Authors:
Gaetano Paone, Emmanuel Itti, Daniela Capacchione, Nicolas Ortonne, Pierre Brugières, Eva Evangelista, Faouzi Kallel, Jean-Pascal Lefaucheur, Alain Créange, Michel Meignan
Published in:
European Journal of Nuclear Medicine and Molecular Imaging
|
Issue 10/2007
Login to get access
Excerpt
Three years after treatment, a 54-year-old woman with a history of uterine cervical epidermoid cancer experienced discomfort in her back associated with right-sided sciatica resistant to medications. MRI revealed a disc hernia (L5–S1) and the patient was referred to surgery with subsequent reduction in pain. One year later, she developed anaesthesia dolorosa and a complete motor deficit in the right sciatic nerve territory. MRI revealed diffuse swelling of the right sacral plexus and a tumoural origin—possibly lymphomatous—was considered. The high signal intensity of the pyramidal muscle observed on the T2-weighted sequence (
a,
arrows) was considered a consequence of muscle denervation. Whole-body [
18F]FDG-PET/CT showed increased uptake in the right sciatic nerve and sacral plexus (
b,
arrowheads). SUV
max was 2.8. The nerve diameter was enlarged on the CT image (
c,
arrows). Fusion with CT (
d) and MRI (
e) demonstrated that [
18F]FDG uptake was confined within the nerve sheath, homogeneously. An open surgical biopsy of the sciatic nerve revealed the presence of endoneural metastatic cells of epidermoid origin.
…