Teaching NeuroImages: Lumbar nerve roots metastasis from prostatic adenocarcinoma
I. Yabe, MD, PhD,
H. Nishimura, MD,
S. Tsuji-Akimoto, MD, PhD,
M. Niino, MD, PhD and
H. Sasaki, MD, PhD
From the Department of Neurology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Address correspondence and reprint requests to Dr. Ichiro Yabe, Department of Neurology, Hokkaido University Graduate School of Medicine, N15 W7 Kita-ku, Sapporo 060-8638, Japan yabe{at}med.hokudai.ac.jp
A 74-year-old man had radiculitis in the left lower extremityfor 1 year. He had undergone radical prostatectomy for prostaticadenocarcinoma 8 years previously. MRI and fludeoxyglucose (FDG)-PETrevealed abnormal swelling and FDG uptake in the left L4 andL5 nerve roots without other systemic metastases (figure, Aand B). Although CSF was normal except for high prostate-specificantigen level, metastatic prostate carcinoma was diagnosed vianeedle biopsy as diagnosis with CSF was not routinely performed1(figure, C). He was treated with luteinizing hormone-releasinghormone agonist without deterioration. Lumbar nerve roots metastasisshould be considered in patients with a history of prostatecancer and radicular symptoms.2
Orphanos G, Ioannidis G, Michael M, Kitrou G. Prostate-specific antigen in the cerebrospinal fluid: a marker of local disease. Med Oncol Epub 2008 Oct 2.
Ladha SS, Spinner RJ, Suarez GA, Amrami KK, Dyck PJ. Neoplastic lumbosacral radiculoplexopathy in prostate cancer by direct perineural spread: an unusual entity. Muscle Nerve 2006;34:659–665.[Medline]
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