Neoplastic Lumbosacral Plexopathy

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Neoplastic Lumbosacral Plexopathy

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Neoplastic lumbosacral plexopathy (NLP) is an infrequent complication associated with advanced systemic cancer due to local or regional progression of the primary tumor. NLP is characterized by significant pain and sensorimotor deficits.

Anatomically, the lumbosacral plexus consists of lumbar (L1-L4) and sacral (L5-S5) portions, which are connected by the lumbosacral trunk (L4-L5). The L1-L4 nerve roots transverse through psoas muscle and then coalesce into the lumbar plexus, which then divides into anterior and posterior divisions. The first three nerves (iliohypogastric, ilioinguinal, femoral) of the seven major branches of lumbar plexus provide motor and sensory innervation to the abdominal wall. The next three nerves (lateral femoral cutaneous, femoral, obturator) innervate the anteromedial thigh. The femoral nerve terminates into the saphenous nerve, providing sensation along the medial aspect of the leg.

The sacral plexus also divides into anterior and posterior divisions, which further divide into various peripheral nerves that provide sensory motor innervation to the posterior hip girdle, thigh, and anterior and posterior leg. The five main nerves are the superior gluteal, inferior gluteal, posterior femoral cutaneous, sciatic, and pudendal nerves. The sciatic nerve divides into the common peroneal and tibial nerves in the thigh.

NLP associated with pelvic, abdominal, and retroperitoneal tumors often results in significant pain, sensory disturbance, weakness, and disability. [1] Plexus involvement occurs as a result of tumor extension or invasion and heralds a progressive disease course. Plexopathy is part of the initial presentation of cancer in 15% of patients.

The clinical diagnosis of NLP is confirmed by magnetic resonance imaging (MRI) or computed tomography (CT) scanning of the affected areas. MRI is preferred because it is more sensitive and provides better detail than CT scanning. [2]

Electrodiagnostic testing reveals abnormalities in almost all patients with neoplastic lumbosacral plexopathy. [3]

Medical or surgical treatment of the carcinoma when possible is the first treatment of choice.

For physical rehabilitation, the likely progression of neurologic weakness needs to be considered. If the patient is noted to have associated weakness after acute pain has subsided, one may recommend active range-of-motion (AROM) exercises, with advancement to low-resistance exercises. Assistive devices, such as a cane, walker, or wheelchair, may be required for ambulation in patients with weakness of the hip extensors, abductors, or quadriceps, with or without loss of joint position sense. Use of an ankle-foot orthosis (AFO) and, in rare cases, a knee-ankle-foot orthosis (KAFO) may be beneficial for mobility.

Patients with more severe and recalcitrant pain may respond to the use of epidural catheter drug delivery and/or neurostimulatory/neuroablative surgical approaches. Cordotomies have been reported to have good outcomes in Europe. However, pain relief has been noted to be transient. Such ablative procedures carry the risk of sensory and motor deficits. The mortality rate has been significant at 5%.

Related Medscape Drugs & Diseases topics:

Diabetic Lumbosacral Plexopathy

Radiation-Induced Lumbosacral Plexopathy

Lumbosacral plexus involvement occurs most commonly due to intra-abdominal tumor extension (73% of cases); it occurs less commonly with growth from metastases, lymph nodes, or bone structures. A tumor can invade the plexus directly or track along the connective tissue or epineurium of nerve trunks.

A study by Capek et al indicated that different types of pelvic neoplasms can lead to lumbosacral plexopathy via the same route, using “splanchnic nerves as conduits” and spreading “from the end organ to the lumbosacral plexus.” They added that these tumors can produce muscle and bone “metastases” by continuing their spread via osseous and muscle nerve branches. [4]

The most prevalent types of tumors are colorectal tumors (20%), sarcomas (16%), breast tumors (11%), lymphoma (9%), and cervical tumors (9%). [5] Other tumors, including multiple myeloma, account for another 37% of cases. The most common distant metastatic lesions are caused by breast cancer. In one study, the lumbosacral plexus was involved in 50 of 2261 cases of cervical cancer; however, it was involved in 38 of the 74 patients (51%) in the subgroup with proven retroperitoneal metastatic disease.

The lower (sacral) plexus is involved most frequently (approximately 50%), followed by upper plexus involvement (more than 30%) and panplexopathy (18%). [6] Bilateral plexopathy occurs in 25% of cases and is usually caused by breast cancer metastases. Lower plexus involvement occurs generally with colorectal and cervical neoplasms. Involvement of the sacral sympathetic nerves is less common (10%).

Malignant psoas syndrome (MPS) was first described in 1990 by Stevens and refers to severe and difficult pain due to proximal lumbosacral plexopathy, painful fixed flexion of the ipsilateral hip, and radiologic or pathologic evidence of malignant involvement of the ipsilateral psoas major muscle. [7]

United States

The incidence of neoplastic lumbosacral plexopathy is 0.71%.

Significant morbidity from neoplastic lumbosacral plexopathy occurs due to associated pain, weakness, and sensory deficits. [8] One study noted median survival of 5.5 months after diagnosis. In patients with prostate cancer, [9] symptoms may persist for years and survival may be longer.

No known correlation is recognized between the incidence of neoplastic lumbosacral plexopathy and race.

One study noted a male-to-female ratio for neoplastic lumbosacral plexopathy of 1.3:1, although the investigation involved just a small number of patients.

In one study, age at the time of presentation of neoplastic lumbosacral plexopathy ranged from 19-80 years, with a median age of 65.5 years.

Jang DH, Byun SH, Jeon JY, Lee SJ. The relationship between lumbosacral plexopathy and pelvic fractures. Am J Phys Med Rehabil. 2011 Sep. 90(9):707-12. [Medline].

Taylor BV, Kimmel DW, Krecke KN, et al. Magnetic resonance imaging in cancer-related lumbosacral plexopathy. Mayo Clin Proc. 1997 Sep. 72(9):823-9. [Medline].

Wilbourn AJ. Electrodiagnosis of plexopathies. Neurol Clin. 1985. 3:511-29. [Medline].

Capek S, Howe BM, Amrami KK, Spinner RJ. Perineural spread of pelvic malignancies to the lumbosacral plexus and beyond: clinical and imaging patterns. Neurosurg Focus. 2015 Sep. 39 (3):E14. [Medline].

Klimek M, Kosobucki R, Luczynska E, Bieda T, Urbanski K. Radiotherapy-induced lumbosacral plexopathy in a patient with cervical cancer: a case report and literature review. Contemp Oncol (Pozn). 2012. 16(2):194-6. [Medline]. [Full Text].

Jaeckle KA, Young DF, Foley KM. The natural history of lumbosacral plexopathy in cancer. Neurology. 1985. 35:8-15. [Medline].

Agar M, Broadbent A, Chye R. The management of malignant psoas syndrome: case reports and literature review. J Pain Symptom Manage. 2004 Sep. 28(3):282-93. [Medline].

Jaeckle KA. Neurological manifestations of neoplastic and radiation-induced plexopathies. Semin Neurol. 2004 Dec. 24(4):385-93. [Medline].

Ladha SS, Spinner RJ, Suarez GA, et al. Neoplastic lumbosacral radiculoplexopathy in prostate cancer by direct perineural spread: an unusual entity. Muscle Nerve. 2006 Nov. 34(5):659-65. [Medline].

Dalmau J, Graus F, Marco M. Hot and dry foot’ as initial manifestation of neoplastic lumbosacral plexopathy. Neurology. 1989 Jun. 39(6):871-2. [Medline].

Dhillon SS, Sarac E. Lumbosacral plexopathy after dual kidney transplantation. Am J Kidney Dis. 2000 Nov. 36(5):1045-8. [Medline].

Garcia-Manzanares MD, Forner-Cordero I, Lavara-Perona MC, et al. Bilateral lumbosacral plexopathy after mesenteric thrombosis. Spinal Cord. 1999 Jul. 37(7):522-5. [Medline].

Stoeckli TC, Mackin GA, De Groote MA. Lumbosacral plexopathy in a patient with pulmonary tuberculosis. Clin Infect Dis. 2000 Jan. 30(1):226-7. [Medline].

Abdelhamid MF, Sandler B, Awad RW. Ischaemic lumbosacral plexopathy following aorto-iliac bypass graft: case report and review of literature. Ann R Coll Surg Engl. 2007 Jul. 89(5):W12-3. [Medline]. [Full Text].

Abdellaoui A, West NJ, Tomlinson MA, et al. Lower limb paralysis from ischaemic neuropathy of the lumbosacral plexus following aorto-iliac procedures. Interact Cardiovasc Thorac Surg. 2007 Aug. 6(4):501-2. [Medline]. [Full Text].

Melikoglu MA, Kocabas H, Sezer I, et al. Internal iliac artery pseudoaneurysm: an unusual cause of sciatica and lumbosacral plexopathy. Am J Phys Med Rehabil. 2008 Aug. 87(8):681-3. [Medline].

You JS, Park YS, Park S, et al. Lumbosacral plexopathy due to common iliac artery aneurysm misdiagnosed as intervertebral disc herniation. J Emerg Med. 2008 Jul 8. [Medline].

Wouter van Es H, Engelen AM, Witkamp TD, et al. Radiation-induced brachial plexopathy: MR imaging. Skeletal Radiol. 1997 May. 26(5):284-8. [Medline].

Soldatos T, Andreisek G, Thawait GK, Guggenberger R, Williams EH, Carrino JA, et al. High-resolution 3-T MR neurography of the lumbosacral plexus. Radiographics. 2013 Jul-Aug. 33(4):967-87. [Medline].

Ahmad A, Barrington S, Maisey M, et al. Use of positron emission tomography in evaluation of brachial plexopathy in breast cancer patients. Br J Cancer. 1999 Feb. 79(3-4):478-82. [Medline].

Son BC, Yoon JH, Kim DR, Lee SW. Dorsal rhizotomy for pain from neoplastic lumbosacral plexopathy in advanced pelvic cancer. Stereotact Funct Neurosurg. 2014. 92 (2):109-16. [Medline].

Sloan P, Basta M, Storey P, et al. Mexiletine as an adjuvant analgesic for the management of neuropathic cancer pain. Anesth Analg. 1999 Sep. 89(3):760-1. [Medline]. [Full Text].

Crosby V, Wilcock A, Corcoran R. The safety and efficacy of a single dose (500 mg or 1 g) of intravenous magnesium sulfate in neuropathic pain poorly responsive to strong opioid analgesics in patients with cancer. J Pain Symptom Manage. 2000 Jan. 19(1):35-9. [Medline].

Russi EG, Pergolizzi S, Gaeta M, et al. Palliative-radiotherapy in lumbosacral carcinomatous neuropathy. Radiother Oncol. 1993 Feb. 26(2):172-3. [Medline].

Dahele M, Davey P, Reingold S, et al. Radiation-induced lumbo-sacral plexopathy (RILSP): an important enigma. Clin Oncol (R Coll Radiol). 2006 Jun. 18(5):427-8. [Medline].

Ebner I, Anderl H, Mikuz G, et al. [Plexus neuropathy: tumor infiltration or radiation damage]. Rofo. 1990 Jun. 152(6):662-6. [Medline].

Inoue C, Hayashi A, Yoshizawa T, et al. [Effect of intravenous immunoglobulin therapy in a case of idiopathic recurrent brachial and lumbosacral plexopathy]. Rinsho Shinkeigaku. 1999 Jun. 39(6):661-4. [Medline].

Pettigrew LC, Glass JP, Maor M, et al. Diagnosis and treatment of lumbosacral plexopathies in patients with cancer. J Arch Neurol. 1984. 41:1282-5. [Medline].

Planner AC, Donaghy M, Moore NR. Causes of lumbosacral plexopathy. Clin Radiol. 2006 Dec. 61(12):987-95. [Medline].

Stubgen JP. Neuromuscular disorders in systemic malignancy and its treatment. Muscle Nerve. 1995 Jun. 18(6):636-48. [Medline].

Thomas JE, Cascino TL, Earle JD. Differential diagnosis between radiation and tumor plexopathy of the pelvis. Neurology. 1985 Jan. 35(1):1-7. [Medline].

Rajesh R Yadav, MD Associate Professor, Section of Physical Medicine and Rehabilitation, MD Anderson Cancer Center, University of Texas Medical School at Houston

Rajesh R Yadav, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Michael T Andary, MD, MS Professor, Residency Program Director, Department of Physical Medicine and Rehabilitation, Michigan State University College of Osteopathic Medicine

Michael T Andary, MD, MS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Medical Association, Association of Academic Physiatrists

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Allergan<br/>Received honoraria from Allergan for speaking and teaching. for: Allergan.

Robert H Meier, III, MD Director, Amputee Services of America; Active Medical Staff, Presbyterian/St Luke’s Hospital, Spalding Rehabilitation Hospital, Select Specialty Hospital; Consulting Staff, Kindred Hospital

Robert H Meier, III, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists

Disclosure: Nothing to disclose.

Neoplastic Lumbosacral Plexopathy

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