Prostate cancer with perineural spread and dural extension causing bilateral lumbosacral plexopathy: Case report - Abstract

Perineural tumor spread in prostate cancer is emerging as a mechanism to explain select cases of neurological dysfunction and as a cause of morbidity and tumor recurrence.

Perineural spread has been shown to extend from the prostate bed to the lumbosacral plexus and then distally to the sciatic nerve or proximally to the sacral and lumbar nerves and even intradurally. The authors present a case of a bilateral neoplastic lumbosacral plexopathy that can be explained anatomically as an extension of the same process: from one lumbosacral plexus to the contralateral one utilizing the dural sac as a bridge between the opposite sacral nerve roots. Their theory is supported by sequential progression of symptoms and findings on clinical examinations as well as high-resolution imaging (MRI and PET/CT scans). The neoplastic nature of the process was confirmed by a sciatic nerve fascicular biopsy. The authors believe that transmedian dural spread allows continuity of a neoplastic process from one side of the body to the other.

Written by:
Capek S, Howe BM, Tracy JA, García JJ, Amrami KK, Spinner RJ.   Are you the author?
Departments of Neurosurgery, Radiology, Neurology, and Anatomic Pathology, Mayo Clinic, Rochester, Minnesota.

Reference: J Neurosurg. 2015 Feb 6:1-6.
doi: 10.3171/2014.12.JNS141339

PubMed Abstract
PMID: 25658791 Prostate Cancer Section


Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.