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Related Experiment Videos

Intraneural nerve metastasis with multiple mononeuropathies.

W Grisold1, H Piza-Katzer, R Jahn

  • 1LBI for NeuroOncology, KFJ Hospital, Vienna, Austria. 106110.1145@compuserve.com

Journal of the Peripheral Nervous System : JPNS
|July 10, 2001
PubMed
Summary

Neoplastic involvement of the peripheral nervous system is rare. This case report highlights intranerval metastasis as a cause of multiple mononeuropathies, mimicking multiplex neuropathy.

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Area of Science:

  • Neurology
  • Oncology
  • Peripheral Nervous System Neoplasms

Background:

  • Neoplastic involvement of the peripheral nervous system (PNS) is uncommon, with varied mechanisms including local invasion, compression, and perineurial spread.
  • Intranerval metastasis, a rare form of PNS involvement, presents diagnostic challenges.

Observation:

  • A 47-year-old woman with a history of carcinoid and axillary irradiation presented with progressive weakness and pain in the left arm.
  • Initial magnetic resonance imaging (MRI) of the brachial plexus was negative, with symptoms attributed to postradiation plexopathy.
  • Surgical exploration revealed a metastasis within the musculocutaneous nerve, which was resected.

Findings:

  • Following initial resection, the patient developed new symptoms in the ulnar nerve, including numbness and pain.

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  • A second intrafascicular metastasis was discovered within the ulnar nerve and surgically resected, preserving fascicular function.
  • This case demonstrates intranerval metastasis manifesting as multiple mononeuropathies.

    • Implications:

    • Intranerval metastasis should be considered in the differential diagnosis of patients with unexplained peripheral neuropathies, especially those with a history of cancer.
    • Early recognition and surgical intervention, where feasible, may help preserve neurological function.
    • This case underscores the importance of considering rare metastatic patterns in oncology patients with neurological deficits.