Syndrome | Description |
Cervical plexopathy | Aching and burning pain in periauricular or postauricular area, or anterior neck |
Pain may be referred to the lateral aspect of the face, head, or shoulder | |
Brachial plexopathy | Moderate to severe pain with component that is dysesthetic and described as burning or freezing |
Allodynia may accompany pain | |
Lumbosacral plexopathies | Presents as pain, followed by numbness, paresthesias, or weakness |
Other symptoms include focal tenderness, leg edema, and positive direct or reverse straight leg raising signs | |
Distribution of pain is related to the location of the neoplasm: | |
- Upper lumbosacral plexopathy (L1-4): Pain experienced in the anterolateral thigh, knee, and proximal leg/lower abdomen; generally caused by low abdominal tumors; upper lumbosacral plexopathy associated with malignant involvement of the psoas major muscle is termed "malignant psoas syndrome" | |
- Lower lumbosacral plexopathy (L4-S1): Pain may be focal in buttocks and perineum and referred to posterolateral thigh and leg; weakness or sensory changes in L5 and S1 dermatomes; leg edema, bladder dysfunction, or bowel dysfunction; generally caused by sigmoid or rectal tumors | |
- Sacral plexopathy (S1-3): May lead to dysesthesias in buttocks, perineum, or posterior legs; pain often severe while sitting, less severe while standing, and least severe while walking; numbness over the dorsolateral foot and weak ankle dorsiflexion; mostly associated with low midline tumors (eg, rectal cancer) | |
- Panplexopathy: Pain anywhere from lower abdomen, back, buttocks, or perineum; referred pain experienced anywhere in the distribution of the plexus | |
- Coccygeal plexopathy (S4-coccygeal nerve): May present as anal pain, numbness, and sphincter dysfunction; most common with rectal and prostate tumors |
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