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Open Access Case report

Intraneural metastasis of gastric carcinoma leads to sciatic nerve palsy

Jiro Ichikawa1, Seiichi Matsumoto1*, Takashi Shimoji1, Taisuke Tanizawa1, Tabu Gokita1, Keiko Hayakawa1, Kaoru Aoki1, Saori Ina1 and Hiroaki Kanda2

Author Affiliations

1 Department of Orthopaedic Surgery, Cancer Institute Hospital for Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan

2 Department of Pathology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan

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BMC Cancer 2012, 12:313  doi:10.1186/1471-2407-12-313

Published: 25 July 2012

Abstract

Background

Soft tissue metastases, in particular intraneural metastasis, from any carcinomas seldom occur. To our knowledge, no case of sciatic nerve palsy due to intraneural metastasis of gastric carcinoma is reported in the literature.

Case presentation

A case is reported of a 82-year old woman with sciatic nerve palsy with intraneural metastasis of gastric carcinoma. Although she had undergone partial gastrectomy with T2b, N0, M0 two years ago and primary site was cured, she developed sciatic nerve palsy from the carcinoma metastasis directly to the nerve. Operative resection and Histological examination revealed poorly differentiated adenocarcinoma, the same as her primary site adenocarcinoma.

Conclusions

Sciatica is usually caused by a herniated disc or spinal canal stenosis. Sciatic nerve palsy may be caused by nondiscogenic etiologies that may be either intrapelvic or extrapelvic. It is important to image the entire course of the nerve to distinguish these etiologies quickly. The longer the nerve compression the less likely a palsy will recover. Surgery is a good intervention that simultaneously obtains a tissue diagnosis and decompresses the nerve.

Keywords:
Intraneural metastasis; Nerve palsy; Palliative surgery