Malignant secondary deposit in the iliac crest masquerading as meralgia paresthetica

Meralgia paresthetica is an entrapment neuropathy from compression of lateral femoral cutaneous nerve of the thigh as it passes under the inguinal ligament. The entrapment produces pain, paresthesia, and sensory loss over the anterolateral aspect of the thigh, without motor loss. The etiology of this condition is often obscure and the pathogenesis is thought to be an entrapment of this nerve at the inguinal ligament where it pierces the fascia to reach the skin. Rarely, retroperitoneal lymphomas or other neoplasms can mimic symptoms of meralgia paresthetica. We report a case of a 60-year-old man who presented with clinical features of meralgia paresthetica. On investigation, he was found to have a secondary malignant deposit in the iliac crest from an adenocarcinoma of the lung. This neuropathy, although often caused by a benign lesion, can at times be the presenting symptom of a malignancy.