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Case Report

Adductor Muscle Atrophy Due to Obturator Nerve Compression by Metastatic Lymph Node Enlargement–A Rare Complication of Recurrent Bladder Cancer

Dhiren J Shah1*, Allan C Andi1, Keith Ramesar2 and Gillian Watson MT3
1Department of Radiology, Guy’s and St. Thomas’ Hospitals NHS Foundation Trust, London, UK
2Departments of Histopathology, Eastbourne District General Hospital, East Sussex Hospitals NHS Trust, East Sussex, UK
3Diagnostic Radiology, Eastbourne District General Hospital, East Sussex Hospitals NHS Trust, East Sussex, UK
Corresponding Author : Janice Dhiren J Shah
Department of Radiology
Guy’s and St. Thomas’ Hospitals NHS Foundation Trust, London, UK
E-mail: dhirenshah@nhs.net
Received March 13, 2013; Accepted March 28, 2013; Published April 04, 2013
Citation: Shah DJ, Andi AC, Ramesar K, Gillian Watson MT (2013) Adductor Muscle Atrophy Due to Obturator Nerve Compression by Metastatic Lymph Node Enlargement–A Rare Complication of Recurrent Bladder Cancer. OMICS J Radiology 2:122. doi: 10.4172/2167-7964.1000122
Copyright: © 2013 Shah DJ, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

 Advanced cancer frequently causes neuropathies or plexopathies if peripheral nerves are invaded. However, isolated obturator mononeuropathy in this setting is exceedingly rare. A 59-year-old male presenting with haematuria went on to have a cystoscopy and trans-urethral resection of a bladder tumour. Histological examination revealed a pT2 grade 3 transitional cell carcinoma, which necessitated a radical cystectomy with ileal conduit. After two cycles of adjuvant chemotherapy he developed severe paraesthesia in his right inner thigh. A pelvic MRI was performed which revealed atrophy of the right adductor muscle group with a proximal obturator node the likely cause of the denervation injury. Neuromuscular symptoms in the context of pelvic cancer should alert the clinician to nerve involvement from either local or metastatic disease. An MRI scan is the ‘gold-standard’ diagnostic test.

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