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BMC Cancer. 2012; 12: 313.
Published online Jul 25, 2012. doi:  10.1186/1471-2407-12-313
PMCID: PMC3476993
Intraneural metastasis of gastric carcinoma leads to sciatic nerve palsy
Jiro Ichikawa,1 Seiichi Matsumoto,corresponding author1 Takashi Shimoji,1 Taisuke Tanizawa,1 Tabu Gokita,1 Keiko Hayakawa,1 Kaoru Aoki,1 Saori Ina,1 and Hiroaki Kanda2
1Department of Orthopaedic Surgery, Cancer Institute Hospital for Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
2Department of Pathology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
corresponding authorCorresponding author.
Jiro Ichikawa: jichi/at/sb4.so-net.ne.jp; Seiichi Matsumoto: smatsumoto/at/jfcr.or.jp; Takashi Shimoji: takashi.shimoji/at/jfcr.or.jp; Taisuke Tanizawa: taisuke.tanizawa/at/jfcr.or.jp; Tabu Gokita: tabu.gokita/at/jfcr.or.jp; Keiko Hayakawa: hayakawakeiko/at/mac.com; Kaoru Aoki: kin29men/at/shinshu-u.ac.jp; Saori Ina: saoriinax/at/gmail.com; Hiroaki Kanda: kandah/at/jfcr.or.jp
Received March 31, 2012; Accepted June 27, 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
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