This Article Figures Only Full Text (PDF) Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Yabe, I. Articles by Sasaki, H. Search for Related Content PubMed PubMed Citation Articles by Yabe, I. Articles by Sasaki, H. Related Collections PET Peripheral neuropathy Metastatic tumor

NEUROLOGY 2009;72:e103-e104
© 2009 American Academy of Neurology

---

Resident and Fellow Section

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 extremity for 1 year. He had undergone radical prostatectomy for prostatic adenocarcinoma 8 years previously. MRI and fludeoxyglucose (FDG)-PET revealed abnormal swelling and FDG uptake in the left L4 and L5 nerve roots without other systemic metastases (figure, A and B). Although CSF was normal except for high prostate-specific antigen level, metastatic prostate carcinoma was diagnosed via needle biopsy as diagnosis with CSF was not routinely performed¹ (figure, C). He was treated with luteinizing hormone-releasing hormone agonist without deterioration. Lumbar nerve roots metastasis should be considered in patients with a history of prostate cancer and radicular symptoms.²

View larger version (84K): [in this window] [in a new window]   Figure Lumbar nerve roots metastasis from prostatic adenocarcinoma (A) T1-weighted gadolinium-enhanced MRI demonstrating abnormally swollen L4 and L5 nerve roots on the left (arrow). (B) Fludeoxyglucose-PET showed abnormal uptake (standardized uptake value; 4.11) in L4 and L5 nerve roots (circle). (C) Immunostaining by prostate-specific antigen (PSA) antibody showed PSA-positive malignant cells (x1,000).

 

---

Disclosure: The authors report no disclosures.

	REFERENCES

Top. REFERENCES

 

1. 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.
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]

This Article Figures Only Full Text (PDF) Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Yabe, I. Articles by Sasaki, H. Search for Related Content PubMed PubMed Citation Articles by Yabe, I. Articles by Sasaki, H. Related Collections PET Peripheral neuropathy Metastatic tumor