Perineural Spread along Spinal and Obturator Nerves in Primary Vaginal Carcinoma: A Case Report.

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Perineural Spread along Spinal and Obturator Nerves in Primary Vaginal Carcinoma: A Case Report.

World Neurosurg. 2018 Apr 13;:

Authors: Song EJ, Park JS, Ryu KN, Park SY, Jin W

Abstract
BACKGROUND: Perineural spread is not uncommon feature in carcinoma of the head and neck. On the contrary, perineural spread in pelvic malignancies has been rarely reported. This report is the first report about perineural spread of obturator nerve and lumbosacral plexus from primary vaginal cancer.
CASE DESCRIPTION: A 50-year-old woman diagnosed with infectious spondylitis at an outside hospital was referred to our institution. She presented with persistent lower back pain and right anterior thigh pain. Magnetic resonance imaging (MRI) and subsequent FDG PET/CT revealed primary vaginal cancer with metastatic lymphadenopathy and perineural spread of lumbosacral plexus, including L3, L4 nerve roots and branches, and obturator nerve along with soft tissue masses in the right psoas and proximal adductor muscles.
CONCLUSIONS: Clinical diagnosis of perineural spread in pelvic malignancies is difficult, as it has nonspecific symptom as an initial manifestation. Clinicians should recognize the possibility of perineural spread of malignancies, if radiologic findings such as thickening of lumbosacral nerves and perineural mass are observed on MRI. Further evaluation is necessary to detect possible pelvic malignancy and differentiate from other diseases.

PMID: 29660549 [PubMed - as supplied by publisher]

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