Abstract
We present a patient with unexplained sciatica (radiating pain down the leg) found to have recurrent prostate adenocarcinoma within the sciatic nerve. High resolution MRI, especially use of an endorectal coil, improved visualization of the perineural spread of the disease. We believe that perineural spread resulting in sciatic symptoms in patients with known prostate adenocarcinoma may be an under-recognized phenomenon. The use of non-invasive modalities, high resolution endorectal coil MRI, and C-11 choline PET/CT can assist in the diagnosis of these patients.
MeSH terms
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Adenocarcinoma / diagnostic imaging
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Adenocarcinoma / pathology*
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Aged, 80 and over
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Biopsy
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Choline
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Fluorodeoxyglucose F18
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Humans
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Lumbosacral Plexus / diagnostic imaging
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Lumbosacral Plexus / pathology*
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Magnetic Resonance Imaging / methods*
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Male
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Multimodal Imaging
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Neoplasm Recurrence, Local
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Positron-Emission Tomography / methods*
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Prostate-Specific Antigen / blood
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Prostatic Neoplasms / diagnostic imaging
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Prostatic Neoplasms / pathology*
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Radiopharmaceuticals
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Sciatic Nerve / diagnostic imaging
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Sciatic Nerve / pathology*
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Tomography, X-Ray Computed / methods*
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Vascular Neoplasms / diagnostic imaging
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Vascular Neoplasms / secondary*
Substances
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Radiopharmaceuticals
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Fluorodeoxyglucose F18
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Prostate-Specific Antigen
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Choline