Brachial Plexus Metastasis Masquerading as Radiation-induced Brachial Plexopathy
CY Wong, SC Wong, YPE Lee, CK Sze, WT Ngai, MW Yeung
Hong Kong J Radiol 2017;20:e7-11
DOI: 10.12809/hkjr1716806
Brachial plexopathy is a form of peripheral neuropathy. Cardinal symptoms include pain, paraesthesia, and weakness across C5 to T1 nerve root distribution. The two major causes of brachial plexopathy in breast cancer patients include tumour recurrence along the path of the brachial plexus and radiation damage to the plexus. Differentiation between the two pathologies is important to guide treatment, but is difficult to make clinically. Magnetic resonance imaging with or without fluorine-18 fluorodeoxyglucose positron emission tomography–computed tomography is a standard approach for differentiation. We report the use of this approach to diagnose metastasis of breast cancer at the brachial plexus.
Authors’ affiliations:
CY Wong, CK Sze, MW Yeung: Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
SC Wong, WT Ngai: Department of Nuclear Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
YPE Lee: Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
中文摘要
癌轉移臂肌叢神經偽類似輻射引致臂肌叢病
王晉彥、 黃思進、李燕蘋、施俊健、魏偉達、楊美雲
臂肌叢病是一種外圍神經病。主要症狀包括C5到T1神經分佈地區疼痛、感覺異常和虛弱。乳腺癌患者臂肌叢病的兩個主要原因包括腫瘤沿臂肌叢路徑復發和放射治療輻射引致的損傷。臨床上區別這兩種病理是困難的，但對指導治療非常重要。使用磁共振成像加或不加上氟-18氟脫氧葡萄糖正電子發射斷層掃描-電腦斷層掃描是區別兩者的標準方法。我們報告使用這種方法去診斷一例乳癌轉移至臂肌叢神經。