Top

Published in:

01-11-2013 | Case Report

Perineural spread of cervical cancer to the sciatic nerve

Authors: Benjamin Matthew Howe, Kimberly K. Amrami, Mark A. Nathan, Joaquin J. Garcia, Robert J. Spinner

Published in: Skeletal Radiology | Issue 11/2013

Abstract

In this report we present a patient with a recent diagnosis of cervical adenocarcinoma with progressive left lower extremity pain and weakness. MR imaging of the pelvis and subsequent FDG CT/PET were complementary in demonstrating abnormalities worrisome for perineural spread of malignancy, which was confirmed with an open fascicular biopsy of the sciatic nerve. We review the imaging and propose a mechanism of perineural spread to the sciatic nerve, which we believe is supported by the imaging in this case.

Amrami KK, Felmlee JP, Spinner RJ. MRI of peripheral nerves. Neurosurg Clin N Am. 2008;19(4):559–72.PubMedCrossRef

Hughes R, Sharrack B, Rubens R. Carcinoma and the peripheral nervous system. J Neurol. 1996;243(5):371–6.PubMedCrossRef

Jaeckle KA. Nerve plexus metastases. Neurol Clin. 1991;9(4):857–66.PubMed

Jaeckle KA, Young DF, Foley KM. The natural history of lumbosacral plexopathy in cancer. Neurology. 1985;35(1):8–15.PubMedCrossRef

Nemzek WR, Hecht S, Gandour-Edwards R, Donald P, McKennan K. Perineural spread of head and neck tumors: how accurate is MR imaging? AJNR Am J Neuroradiol. 1998;19(4):701–6.PubMed

Elsahwi KS, Barber E, Illuzzi J, Buza N, Ratner E, Silasi DA, et al. The significance of perineural invasion in early-stage cervical cancer. Gynecol Oncol. 2011;123(3):561–4.PubMedCrossRef

Memarzadeh S, Natarajan S, Dandade DP, Ostrzega N, Saber PA, Busuttil A, et al. Lymphovascular and perineural invasion in the parametria: a prognostic factor for early-stage cervical cancer. Obstet Gynecol. 2003;102(3):612–9.PubMedCrossRef

Hebert-Blouin MN, Amrami KK, Myers RP, Hanna AS, Spinner RJ. Adenocarcinoma of the prostate involving the lumbosacral plexus: MRI evidence to support direct perineural spread. Acta Neurochir (Wien). 2010;152(9):1567–76.CrossRef

Ladha SS, Spinner RJ, Suarez GA, Amrami KK, Dyck PJ. Neoplastic lumbosacral radiculoplexopathy in prostate cancer by direct perineural spread: an unusual entity. Muscle Nerve. 2006;34(5):659–65.PubMedCrossRef

10.

Rodin AE, Larson DL, Roberts DK. Nature of the perineural space invaded by prostatic carcinoma. Cancer. 1967;20(10):1772–9.PubMedCrossRef

11.

Seefeld PH, Bargen JA. The spread of carcinoma of the rectum: invasion of lymphatics, veins and nerves. Ann Surg. 1943;118(1):76.PubMed

12.

Uchida K, Kobayashi S, Yayama T, Muramatsu J, Kurokawa T, Imamura Y, et al. Metastatic involvement of sacral nerve roots from uterine carcinoma: a case report. Spine J. 2008;8(5):849–52.PubMedCrossRef

13.

Paone G, Itti E, Capacchione D, Ortonne N, Brugieres P, Evangelista E, et al. Image of the month. Diagnosis of endoneural sciatic nerve invasion by uterine cervical epidermoid cancer using [18F]FDG-PET/CT. Eur J Nucl Med Mol Imaging. 2007;34(10):1711–2.PubMedCrossRef

14.

Rob L, Halaska M, Robova H. Nerve-sparing and individually tailored surgery for cervical cancer. Lancet Oncol. 2010;11(3):292–301.PubMedCrossRef

15.

Hoeller U, Bonacker M, Bajrovic A, Alberti W, Adam G. Radiation-induced plexopathy and fibrosis. Is magnetic resonance imaging the adequate diagnostic tool? Strahlenther Onkol. 2004;180(10):650–4.PubMedCrossRef

16.

Wittenberg KH, Adkins MC. MR imaging of nontraumatic brachial plexopathies: frequency and spectrum of findings. Radiographics. 2000;20(4):1023–32.PubMed

17.

Chhabra A, Thakkar RS, Andreisek G, Chalian M, Belzberg AJ, Blakeley J, et al. Anatomic MR imaging and functional diffusion tensor imaging of peripheral nerve tumors and tumorlike conditions. AJNR Am J Neuroradiol. 2013;34(4):802–7.PubMedCrossRef

18.

Thomas JE, Cascino TL, Earle JD. Differential diagnosis between radiation and tumor plexopathy of the pelvis. Neurology. 1985;35(1):1–7.PubMedCrossRef

19.

Thawait SK, Chaudhry V, Thawait GK, Wang KC, Belzberg A, Carrino JA, et al. High-resolution MR neurography of diffuse peripheral nerve lesions. Am J Neuroradiol. 2011;32(8):1365–72.PubMedCrossRef

20.

Gosk J, Rutowski R, Reichert P, Rabczynski J. Radiation-induced brachial plexus neuropathy—aetiopathogenesis, risk factors, differential diagnostics, symptoms and treatment. Folia Neuropathol. 2007;45(1):26–30.PubMed

21.

Wouter van Es H, Engelen AM, Witkamp TD, Ramos LM, Feldberg MA. Radiation-induced brachial plexopathy: MR imaging. Skeletal Radiol. 1997;26(5):284–8.PubMedCrossRef

22.

Bowen BC, Verma A, Brandon AH, Fiedler JA. Radiation-induced brachial plexopathy: MR and clinical findings. AJNR Am J Neuroradiol. 1996;17(10):1932–6.PubMed

23.

Bowen BC, Seidenwurm DJ; Expert Panel on Neurologic Imaging. Plexopathy. Am J Neuroradiol. 2008;29(2):400–2.PubMed

Title: Perineural spread of cervical cancer to the sciatic nerve
Authors: Benjamin Matthew Howe
Kimberly K. Amrami
Mark A. Nathan
Joaquin J. Garcia
Robert J. Spinner
Publication date: 01-11-2013
Publisher: Springer Berlin Heidelberg
Published in: Skeletal Radiology / Issue 11/2013
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI: https://doi.org/10.1007/s00256-013-1653-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Perineural spread of cervical cancer to the sciatic nerve

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 11/2013

Browser’s notes

Characterization of soft tissue masses: can quantitative diffusion weighted imaging reliably distinguish cysts from solid masses?

The physiological range of femoral antetorsion

A case report: radiological findings in an unusual case of calciphylaxis 16 years after renal transplantation

Giant cell tumor with secondary aneurysmal bone cyst: A unique presentation with an ossified extraosseous soft tissue mass

Epiphyseal stress fractures of finger phalanges in adolescent climbing athletes: a 3.0-Tesla magnetic resonance imaging evaluation