We propose that pelvic malignancies can spread to bone and cause bony metastases using nerves as conduits.
We reviewed two cases of pelvic malignancy with perineural spread of bladder cancer and prostate cancer. In a patient with prostate cancer, we identified six lesions that were positive on the 11C-choline PET/CT scan and MRI; in a patient with bladder cancer, we identified two lesions positive on the 18F-deoxy-glucose PET/CT scan and MRI. We carefully reviewed the imaging studies, and using established sclerotome maps we identified spinal nerves supplying each of eight pelvic bony lesions. All these spinal nerves showed evidence of tumor infiltration with extension toward the affected bones. We theorize that perineural tumor spread may serve as an additional mechanism of pelvic osseous metastases in pelvic malignancies.
Written by:
Capek S, Howe BM, Froemming AT, Amrami KK, Spinner RJ. Are you the author?
Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA.
Reference: Skeletal Radiol. 2015 Apr 12. Epub ahead of print.
doi: 10.1007/s00256-015-2143-3
PubMed Abstract
PMID: 25862336