Perineural spread of vaginal cancer involving the lumbosacral plexus

¹⁸F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) shows marked FDG uptake at perineural mass and L3 and L4 spinal nerves (arrows) and obturator nerve (dashed arrow), corresponding to enhancing portions on MRI (not shown). Note additional FDG activity of both iliac lymph nodes, suggestive of metastases (thick arrows).