Lumbar Plexopathy Caused by Metastatic Tumor, Which Was Mistaken for Postoperative Femoral Neuropathy

Abstract

Surgical excision was performed on a 30-years old woman with a painful mass on her left thigh. The pathologic findings on the mass indicated fibromatosis. After the operation, she complained of allodynia and spontaneous pain at the operation site and ipsilateral lower leg. We treated her based on postoperative femoral neuropathy, but symptom was aggravated. We found a large liposarcoma in her left iliopsoas muscle which compressed the lumbar plexus. In conclusion, the cause of pain was lumbar plexopathy related to a mass in the left iliopsoas muscle. Prompt diagnosis of acute neuropathic pain after an operation is important and management must be based on exact causes.

Iliacus hematoma causing late femoral nerve palsy

“…Nerve palsy is observed after direct trauma to the nerve, pelvic surgeries, the presence of a mass compressing the nerve, femoral artery catheterization, and graft harvesting from the iliac wing 10–12 . Studies are reporting that femoral nerve palsy develops after a benign synovial cyst located near the nerve in this region, liposarcoma showing primary malignancy or metastatic features, and ewing sarcoma seen in the pediatric age group 13–16 . Our patient developed partial femoral nerve palsy with gradual progression secondary to hematoma after low‐energy trauma, and this condition developed in the subacute period.…”

“…[10][11][12] Studies are reporting that femoral nerve palsy develops after a benign synovial cyst located near the nerve in this region, liposarcoma showing primary malignancy or metastatic features, and ewing sarcoma seen in the pediatric age group. [13][14][15][16] Our patient developed partial femoral nerve palsy with gradual progression secondary to hematoma after low-energy trauma, and this condition developed in the subacute period.…”