Diagnosis Process and Management of Sciatic Neuralgia Revealing A Lung Adenocarcinoma, A Case Report

Abstract

Sciatic neuralgia is commonly due to lumbar disc herniation.
However, malignancy infiltration of the nerve’s roots must also be
considered. When metastasis is revealed by complication, its
management must follow a particular approach. Authors report one
case of sacral metastasis of a lung adenocarcinoma revealed by
neuralgia and skeletal related events, worsening the patient’s life
quality.
One 65
-
year
-
old man experienced progressive and persistant
left
buttock pain beginning six months earlier, that radiated to the
lower limb following the sciatic path. Progression of its intensity
led to step limitation and disabilities.
Thoracolumbosacral Spine CT scan showed a huge tumoral
mass with osteolytic
process infiltrating all the sacrococcygeal area
(113x112x107 mm) and a malignant vertebral collapse of L1. Pelvic
organ investigations didn’t find any neoplasm. The full body CT
scan found a heterogeneous nodule (21x11 mm) in the left apical
lung lobe. Hi
stopathology after biopsy of the sacral mass and the
pulmonary nodule confirmed the adenocarcinoma and
immunohistochemistry specified its lung origin. Surgical sciatic