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  • Updated 07.06.2021
  • Released 08.18.1997
  • Expires For CME 07.06.2024

Nerve plexus metastases

Introduction

Overview

Metastasis to the brachial plexus is a fairly common complication of breast carcinoma, lung carcinoma, and certain types of lymphoma. Metastatic tumor involving the lumbosacral plexus is an increasingly recognized complication of a number of neoplasms. It is important for neurologists to diagnose metastatic plexopathies and to differentiate them from radiation-induced plexus injury or other etiologies. In this article, the author discusses the clinical presentations, diagnostic issues, and management of patients with metastatic plexopathies.

Key points

• Carcinomas of the lung or breast are the most common sources of brachial plexus metastases, whereas lumbosacral plexus metastases most often arise from primary pelvic tumors or lymphoma.

• Local and radiating pain is the most common presenting symptom of nerve plexus metastasis, eventually followed by motor and sensory deficits.

• MRI is fairly sensitive and specific in diagnosing nerve plexus metastases, and FDG-PET scanning may also be useful in some patients.

• Treatment of nerve plexus metastases usually brings about significant pain relief; motor and sensory deficits are less likely to improve.

• EMG can also be informative, particularly when trying to differentiate between metastatic and radiation-induced plexopathy.

Historical note and terminology

Tumor metastasis to the brachial or lumbosacral plexus is less commonly seen compared to brain metastases. The clinical features of nerve plexus metastases were first clearly delineated in the 1970s.

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