Cause:  Tumor Invasion of:

• Intercostals Spaces
• Paravertebral Spaces
• Retroperitoneal Spaces

Symptoms: Due to Peripheral Nerve Involvement:

• Constant burning pain with dysesthesia.
• Pain is radicular and usually unilateral

Involvement due to nerve compression or infiltration is most commonly seen by tumors which invade the intercostal, the paravertebral or the retroperitoneal spaces.

Symptoms of peripheral nerve involvement: Constant burning pain with dysesthesia. in an area of sensory loss. Pain is radicular and usually unilateral. Documentation of the entrapped nerve can be done using CT scanning of the anatomic region of nerve compression.

Cause: Direct Infiltration or Compression Upon the Nerve By Tumor or Metastasis

Effects: Burning, Tingling Numbing in 95% of Patients
Neurological Findings : Weakness, Atrophy of Hand Muscles, Horner's Syndrome, (ptosis, miosis, anhidrosis)

Pain is the initial symptom in 95% of patients with Brachial plexopathy .

The most common neurological findings are weakness and atrophy of hand muscles. With upper brachial plexus involvement the thumb and index finger are most commonly involved. In the lower brachial plexus, the 4th and 5th fingers are usually involved. HornerÕs Syndrome (ptosis, miosis, anhidrosis) is common.

Pain can be caused by radiation fibrosis, as well as tumor. The common distinguishing factor being: neurological signs precede onset of pain when the etiology is radiation fibrosis. CT scanning is the most useful diagnostic tool in assessment of this syndrome.

Cause: Direct Infiltration or Compression Upon the Nerve By Tumor or Metastasis

Effects:
Constant Dull, Aching, Pressure-Like Sensation In Hip or Sacral Areas. Occasional Sensation of Burning.
Neurological Findings :
Lower Plexus: Foot Drop, Pelvic Lordosis, Numbness of Thigh, Sole, and Perineum.
Upper Plexus: Motor loss is manifested by flexor weakness with difficulty negotiating stairs. Sensory loss is most often numbness in anterior thigh.

Lumbosacral plexopathy is seen in patients with locally extensive cancers of the prostate, testicle, rectum, bladder or cervix.

Pain is usually the first symptom of plexus involvement, followed weeks later by sensory and motor loss in the lower extremity. This pain us a constant dull, aching, pressure-like sensation in the hip or sacral areas with only occasional sensations of burning pain in those areas. Incontinence is associated only about 10% of the time.

The lower part of the plexus is most often involved. The nerve roots L5 to S3 are the most common nerve roots involved. Most common clinical signs are foot drop, pelvic lordosis. Numbness of the thigh, the sole of the foot, and perineum.

The upper plexus can also be invaded by tumor. Motor loss is manifested by flexor weakness with difficulty in negotiating stairs. Sensory loss is most often numbness in the anterior high.

Differential Diagnosis:

• Aortic aneurysm
• Diabetes mellitus
• Trauma
• Lumbosacral neuritis

Cause: Direct Infiltration or Compression Upon the Nerve By Tumor or Metastasis

Effects: Burning, Tingling Numbing in 95% of Patients.
Neurological Findings: Weakness, Atrophy of Hand Muscles, Horner's Syndrome, (ptosis, miosis, anhidrosis)

Pain occurs in 40% of patients who have Leptomeningeal disease. Headache without neck stiffness is a common finding.

Low back pain and vomiting are frequent complaints. Patients often present with cognitive failure (somnolence, mental confusion) and cranial nerve involvement.

The best way to make a diagnosis is a lumbar puncture to recover malignant cells from the spinal fluid. Elevated cerebrospinal fluid protein and low glucose concentrations are frequently associated with this syndrome. MRI with gadolinium contrast frequently shows increased signal in the meninges.