Malignant secondary deposit in the iliac crest masquerading as meralgia paresthetica

doi:10.1016/S0003-9993(97)90067-8

Archives of Physical Medicine and Rehabilitation

Volume 78, Issue 9, September 1997, Pages 1010-1011

https://doi.org/10.1016/S0003-9993(97)90067-8 Get rights and content

Abstract

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.

References (5)

GJ Rinkel et al.
Meralgia paresthetica as the first symptom of a metastatic tumor in the lumbar spine
Clin Neurol Neurosurg
(1990)
J Kimura
Electro diagnosis in diseases of nerve and muscle—Principles and Practices

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Cited by (27)

Lower extremity: Lateral femoral cutaneous nerve block. lateral femoral cutaneous nerve block.
2011, Pain Procedures in Clinical Practice: Expert Consult
Lower Extremity: Lateral Femoral Cutaneous Nerve Block
2011, Pain Procedures in Clinical Practice
Meralgia paresthetica: A result of tight new trendy low cut trousers ('taille basse')
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Citation Excerpt :
The primary cause of meralgia paresthetica remains obscure although it is associated with many etiologic factors. A variety of causes for meralgia paresthetica have been reported, including direct trauma, seat belt injurym,26 laparoscopic inguinal hernia repair,7 myomectomy,15 cholecystectomy,38 abdominal distention,10 limb length discrepancy,12 metastatic carcinoma in the iliac crest,34 retroperitoneal tumors,11 and idiopathic causes.24 Obesity and pregnancy are other causes acting through exerting pressure on the lateral cutaneous nerve.19
Meralgia paresthetica is an entrapment neuropathy involving the lateral femoral cutaneous nerve of the thigh. Patients complain of a persistent burning sensation, tingling and aching pain, and hypersensitivity or hyposensitivity in the anterolateral aspect of the thigh. Numerous direct and indirect causes for the disease have been suggested in the literature.
We present 12 cases that were diagnosed to have meralgia paresthetica due to tight new fashion low cut trousers (‘taille basse’). The diagnosis was confirmed by injecting a small amount of a short acting local anesthetic around the lateral femoral cutaneous nerve which alleviated the symptoms for several hours. Electrophysiologic studies were sensitive in 83.3% of the cases.
All cases were treated successfully using conservative methods, namely avoiding tight trousers, local steroid infiltration and weight reduction.
Meralgia paresthetica after liver transplantation: A case report
2005, Transplantation Proceedings
The focal neuropathies after orthotropic liver transplantation (OLTx) have been well documented to date. Most injuries to the peripheral nervous system involve the peroneal nerve and brachial plexus. We report the first case of lateral femoral cutaneous nerve (LFCN) injury after OLTx. The patient presented with pain and numbness on the lateral aspect of the right thigh that had progressively worsened since operation. Electrodiagnostic studies were indicative for right meralgia paresthetica (MP). The symptoms of MP improved progressively after physical therapy applications during the first 3 months. The etiology of MP in this case is unclear. However, it may be considered that ascites, surgical mechanisms, and immunosuppressive therapy were possible causative factors.
Cancer pain syndromes
2003, Handbook of Pain Management: A Clinical Companion to Textbook of Pain
Backpacking-induced paresthesias
2003, Wilderness and Environmental Medicine
To evaluate the presence of numbness and paresthesias among long-distance backpackers on the Appalachian Trail.
Backpackers who hiked a minimum of 7 days were interviewed while hiking. Following their hike, a written questionnaire was mailed to the participants that explored the incidence of injuries and illnesses among hikers. Paresthesias were defined as either numbness or “phantom, burning, or shooting pains.” A case-control analysis of risk factors for paresthesias was performed.
Paresthesias were reported by 34% (96 of 280) of the backpackers completing the study. They included ulnar paresthesias (n = 4), meralgia paresthetica (n = 10), tarsal tunnel syndrome (n = 6), digitalgia paresthetica (n = 21), and nonspecific paresthesias (n = 61). The most common symptom was numbness: 81% (78 of 96). Significant risk factors included a distance of >2000 miles (relative risk [RR] = 1.3; 95% CI, 1.1–1.6; P = .01) and the duration of hiking (RR = 2.0; 95% CI, 1.2–3.2; P = .004) for the longest quartile. Nonsignificant factors included backpack weight, initial body weight, percentage of weight loss, running shoe usage, and multivitamin usage. Ninety-eight percent of the paresthesias (94 of 96) had resolved by the time of follow-up (median = 30 days).
Paresthesias were a surprisingly common complaint among long-distance backpackers. Although they were distressing during backpacking, these neuropathies were self-limited and resolved after completion of hiking.

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Clinical noteMalignant secondary deposit in the iliac crest masquerading as meralgia paresthetica☆

Abstract

Clin Neurol Neurosurg

Electro diagnosis in diseases of nerve and muscle—Principles and Practices

Clinical note
Malignant secondary deposit in the iliac crest masquerading as meralgia paresthetica☆