{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:21:25Z","timestamp":1789053685811,"version":"build-2803163510"},"reference-count":150,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2015,9]]},"abstract":"\n OBJECT<\/jats:title>\n Perineural spread along pelvic autonomie nerves has emerged as a logical, anatomical explanation for selected cases of neoplastic lumbosacral plexopathy (LSP) in patients with prostate, bladder, rectal, and cervical cancer. The authors wondered whether common radiological and clinical patterns shared by various types of pelvic cancer exist.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n The authors retrospectively reviewed their institutional series of 17 cases concluded as perineural tumor spread. All available history, physical examination, electrodiagnostic studies, biopsy data and imaging studies, evidence of other metastatic disease, and follow-up were recorded in detail. The series was divided into 2 groups: cases with neoplastic lumbosacral plexopathy confirmed by biopsy (Group A) and cases included based on imaging characteristics despite the lack of biopsy or negative biopsy results (Group B).<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Group A comprised 10 patients (mean age 69 years); 9 patients were symptomatic and 1 was asymptomatic. The L5\u2013S1 spinal nerves and sciatic nerve were most frequently involved. Three patients had intradural extension. Seven patients were alive at last follow-up. Group B consisted of 7 patients (mean age 64 years); 4 patients were symptomatic, 2 were asymptomatic, and 1 had only imaging available. The L5\u2013S1 spinal nerves and the sciatic nerve were most frequently involved. No patients had intradural extension. Four patients were alive at last follow-up.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n The authors provide a unifying theory to explain lumbosacral plexopathy in select cases of various pelvic neoplasms. The tumor cells can use splanchnic nerves as conduits and spread from the end organ to the lumbosacral plexus. Tumor can continue to spread along osseous and muscle nerve branches, resulting in muscle and bone \u201cmetastases.\u201d Radiological studies show a reproducible, although nonspecific pattern, and the same applies to clinical presentation.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2015.7.focus15209","type":"journal-article","created":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T03:41:33Z","timestamp":1441078893000},"page":"E14","source":"Crossref","is-referenced-by-count":74,"title":["Perineural spread of pelvic malignancies to the lumbosacral plexus and beyond: clinical and imaging patterns"],"prefix":"10.3171","volume":"39","author":[{"given":"Stepan","family":"Capek","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"2nd Faculty of Medicine, Charles University in Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin M.","family":"Howe","sequence":"additional","affiliation":[{"name":"Radiology, Mayo Clinic, Rochester, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly K.","family":"Amrami","sequence":"additional","affiliation":[{"name":"Radiology, Mayo Clinic, Rochester, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Spinner","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus15209","series-title":"Acta Neurochir (Wien)","first-page":"2331","article-title":"Perineural tumor spread of bladder cancer causing lumbosacral plexopathy: an anatomic explanation","volume":"156","author":"Aghion","year":"2014"},{"key":"b2-focus15209","series-title":"Spine (Phila Pa 1976)","first-page":"260","article-title":"Renal cell carcinoma and intradural spinal metastasis with cauda equina infiltration: case report\u2014part II","volume":"30","author":"Alfleri","year":"2005"},{"key":"b3-focus15209","series-title":"Brain Res Bull","first-page":"1","article-title":"The blood-nerve barrier: enzymes, transporters and receptors\u2014-a comparison with the blood-brain barrier","volume":"52","author":"Allt","year":"2000"},{"key":"b4-focus15209","series-title":"Cancer Res","first-page":"6082","article-title":"Growth and survival mechanisms associated with perineural invasion in prostate cancer","volume":"64","author":"Ayala","year":"2004"},{"key":"b5-focus15209","series-title":"Prostate","first-page":"266","article-title":"Bystin in perineural invasion of prostate cancer","volume":"66","author":"Ayala","year":"2006"},{"key":"b6-focus15209","series-title":"Cancer Res","first-page":"5159","article-title":"Stromal antiapoptotic paracrine loop in perineural invasion of prostatic carcinoma","volume":"66","author":"Ayala","year":"2006"},{"key":"b7-focus15209","series-title":"Prostate","first-page":"213","article-title":"In vitro dorsal root ganglia and human prostate cell line interaction: redefining perineural invasion in prostate cancer","volume":"49","author":"Ayala","year":"2001"},{"key":"b8-focus15209","series-title":"Clin Anat","first-page":"119","article-title":"Topography of the pelvic autonomic nervous system and its potential impact on surgical intervention in the pelvis","volume":"16","author":"Baader","year":"2003"},{"key":"b9-focus15209","series-title":"Abdom Imaging","first-page":"1155","article-title":"Recurrent prostatic adenocarcinoma with perineural spread to the lumbosacral plexus and sciatic nerve: comparing high resolution MRI with torso and endorectal coils and F-18 FDG and C-11 choline PET\/CT","volume":"38","author":"Babu","year":"2013"},{"key":"b10-focus15209","series-title":"Cancer","first-page":"434","article-title":"Metastasis to organs in carcinoma of the uterine cervix. 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