title: Perineural tumor spread of bladder cancer causing lumbosacral plexopathy: an anatomic explanation.
abstract: We present two cases of biopsy-proven neoplastic lumbosacral plexopathy from perineural spread of bladder cancer: one patient presented with predominantly sciatic nerve involvement and the second predominantly with obturator nerve involvement. These two patterns of perineural spread from bladder cancer were supported by imaging in our cases and solidified by review of the literature. Based on the innervation of the bladder, we provide an anatomic explanation for this observation. To our best knowledge, such an anatomic, mechanistic basis for perineural tumor spread in bladder cancer has not yet been described.
authors.affiliation: Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, USA.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Aghion
authors.forename: Stepan
authors.initials: S
authors.lastname: Capek
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Howe
authors.forename: Jaroslaw T
authors.initials: JT
authors.lastname: Hepel
authors.forename: Sundaresan
authors.initials: S
authors.lastname: Sambandam
authors.forename: Adetokunbo A
authors.initials: AA
authors.lastname: Oyelese
authors.forename: Adeotounbo A
authors.initials: AA
authors.lastname: Oyelese
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Spinner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy; D006801:Humans; D008160:Lumbosacral Plexus / Q000473:pathology; D008297:Male; D010525:Peripheral Nerves / Q000473:pathology; D010523:Peripheral Nervous System Diseases / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy