title: Pelvic radiculopathies, lumbosacral plexopathies, and neuropathies in oncologic disease: a multidisciplinary approach to a diagnostic challenge.
abstract: The purpose of this article is to familiarize the reader with the anatomy of the major pelvic nerves and the clinical features of associated lumbosacral plexopathies. To demonstrate this we illustrate several cases of malignant lumbosacral plexopathy on computed tomography, magnetic resonance imaging, and positron emission tomography/computed tomography. A new lumbosacral plexopathy in a patient with a prior history of abdominal or pelvic malignancy is usually of malignant etiology. Biopsies may be required to definitively differentiate tumour from posttreatment fibrosis, and in cases of inconclusive sampling or where biopsies are not possible, follow-up imaging may be necessary. In view of the complexity of clinical findings often confounded by a history of prior surgery and/or radiotherapy, a multidisciplinary approach between oncologists, neurologists, and radiologists is often required for what can be a diagnostic challenge.
authors.affiliation: Brighton and Sussex University Hospitals NHS Trust, Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, UK.
authors.forename: Nick
authors.initials: N
authors.lastname: Brejt
authors.affiliation: Cumberland Infirmary, Newtown Road, Carlisle CA2 7HY, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Berry
authors.affiliation: Sleep Neurology Clinic (NHS), Sleep Disorders Centre, Queen Victoria Hospital NHS Foundation Trust, Holtye Road, East Grinstead, West Sussex RH19 3DZ, UK.
authors.forename: Angus
authors.initials: A
authors.lastname: Nisbet
authors.affiliation: Brighton and Sussex University Hospitals NHS Trust, Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, UK.
authors.forename: David
authors.initials: D
authors.lastname: Bloomfield
authors.affiliation: Brighton and Sussex University Hospitals NHS Trust, Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, UK.
authors.forename: Guy
authors.initials: G
authors.lastname: Burkill
mesh_terms: D006801:Humans; D008160:Lumbosacral Plexus / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D010386:Pelvic Neoplasms / Q000150:complications* / Q000532:radiotherapy; D010388:Pelvis / Q000294:innervation; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis* / Q000209:etiology; D049268:Positron-Emission Tomography; D011843:Radiculopathy / Q000175:diagnosis*; D050397:Radiotherapy, Intensity-Modulated; D014057:Tomography, X-Ray Computed