Malignant psoas syndrome associated with gynecological malignancy: Three case reports and a review of the literature

  • Authors:
    • Shiro Takamatsu
    • Kosuke Murakami
    • Hisamitsu Takaya
    • Takako Tobiume
    • Hidekatsu Nakai
    • Ayako Suzuki
    • Masaki Mandai
    • Noriomi Matsumura
  • View Affiliations

  • Published online on: May 21, 2018     https://doi.org/10.3892/mco.2018.1635
  • Pages: 82-86
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )


Abstract

Malignant psoas syndrome (MPS) is a rare and unique cancer‑associated syndrome caused by the malignant involvement of the psoas major muscle, and is characterized by ipsilateral lumbosacral plexopathy and painful hip flexion. The pain in MPS is often distressing and intractable, and there is no established effective treatment approach. Herein, the present study reports on three cases of MPS associated with gynecological malignancies, wherein symptom improvement was observed following chemotherapy or radiotherapy. Among 39 cases documented in the literature, female genital tract malignancies were the most frequent causes of MPS; however, the condition may be under‑diagnosed, owing to the lack of general recognition. Considering the development of recent high‑precision radiation therapy, palliative radiotherapy may serve an important role in the management of MPS. For physicians treating gynecological cancers, early detection of MPS is clinically important as this may allow patients to receive possible therapies and improve their quality of life in end‑stage cancer. Further prospective studies should be performed to evaluate effective therapeutic approaches for MPS.

References

1 

Stevens MJ and Gonet YM: Malignant psoas syndrome: Recognition of an oncologic entity. Australas Radiol. 34:150–154. 1990. View Article : Google Scholar : PubMed/NCBI

2 

Agar M, Broadbent A and Chye R: The management of malignant psoas syndrome: Case reports and literature review. J Pain Symptom Manage. 28:282–293. 2004. View Article : Google Scholar : PubMed/NCBI

3 

Stevens MJ, Atkinson C and Broadbent AM: The malignant psoas syndrome revisited: Case report, mechanisms, and current therapeutic options. J Palliat Med. 13:211–216. 2010. View Article : Google Scholar : PubMed/NCBI

4 

Jaeckle KA: Neurological manifestations of neoplastic and radiation-induced plexopathies. Semin Neurol. 24:385–393. 2004. View Article : Google Scholar : PubMed/NCBI

5 

McKay TA, Bishop S and McKay MJ: Primary psoas sarcoma causing malignant psoas syndrome: Favourable response to radiotherapy. Ann Transl Med. 5:1052017. View Article : Google Scholar : PubMed/NCBI

6 

Takase N, Ikegaki J, Nishimura H, Yuasa S, Ito Y and Kizawa Y: Methadone for patients with malignant psoas syndrome: Case series of three patients. J Palliat Med. 18:645–652. 2015. View Article : Google Scholar : PubMed/NCBI

7 

Kounami S, Shibuta K, Yoshiyama M, Mitani Y, Watanabe T, Takifuji K and Yoshikawa N: Primary anaplastic large cell lymphoma of the psoas muscle: A case report and literature review. Acta Haematol. 127:186–188. 2012. View Article : Google Scholar : PubMed/NCBI

8 

Basu S and Mahajan A: Psoas muscle metastasis from cervical carcinoma: Correlation and comparison of diagnostic features on FDG-PET/CT and diffusion-weighted MRI. World J Radiol. 6:125–129. 2014. View Article : Google Scholar : PubMed/NCBI

9 

Ota T, Makihara M, Tsukuda H, Kajikawa R, Inamori M, Miyatake N, Tanaka N, Tokunaga M, Hasegawa Y, Tada T and Fukuoka M: Pain management of malignant psoas syndrome under epidural analgesia during palliative radiotherapy. J Pain Palliat Care Pharmacother. 31:154–157. 2017. View Article : Google Scholar : PubMed/NCBI

10 

Yang WT, Yeo W and Metreweli C: Imaging of iliopsoas metastasis. Clin Radiol. 54:85–89. 1999. View Article : Google Scholar : PubMed/NCBI

11 

Ampil FL, Lall C and Datta R: Palliative management of metastatic tumors involving the psoas muscle: Case reports and review of the literature. Am J Clin Oncol. 24:313–314. 2001. View Article : Google Scholar : PubMed/NCBI

12 

Connor SE, Chavda SV and West R: Recurrence of non-Hodgkin's lymphoma isolated to the right masticator and left psoas muscles. Eur Radiol. 10:841–843. 2000. View Article : Google Scholar : PubMed/NCBI

13 

Avery GR: Metastatic adenocarcinoma masquerading as a psoas abscess. Clin Radiol. 39:319–320. 1988. View Article : Google Scholar : PubMed/NCBI

14 

Bar-Dayan Y, Fishman A, Levi Z and Rachmani R: Squamous cell carcinoma of the cervix with psoas abscess-like metastasis in an HIV-negative patient. Isr J Med Sci. 33:674–676. 1997.PubMed/NCBI

15 

Linn JF, Fichtner J, Voges G, Schweden F, Störkel S and Hohenfellner R: Solitary contralateral psoas metastasis 14 years after radical nephrectomy for organ confined renal cell carcinoma. J Urol. 156:1731996. View Article : Google Scholar : PubMed/NCBI

16 

Elkowitz SS, Patel M and Hirschfield LS: Paravertebral muscle metastases from primary tongue and nasopharyngeal carcinomas. Clin Radiol. 43:400–401. 1991. View Article : Google Scholar : PubMed/NCBI

17 

Cortés-Blanco A and Martínez-Lázaro R: Lymphoma mimicking a psoas abscess on Ga-67 scintigraphy. Clin Nucl Med. 25:567–568. 2000. View Article : Google Scholar : PubMed/NCBI

18 

Nash S, Rubenstein J, Chaiton A and Morava-Protzner I: Adenocarcinoma of the lung metastatic to the psoas muscle. Skeletal Radiol. 25:585–587. 1996. View Article : Google Scholar : PubMed/NCBI

19 

Yamaguchi T, Katayama K, Matsumoto M, Sato Y, Nakayama N and Hisahara K: Successful control of pain from malignant psoas syndrome by spinal opioid with local anesthetic agents. Pain Pract: 23 Sep 2017 (Epub ahead of print).

20 

Porta-Sales J, Garzón-Rodríguez C, Villavicencio-Chávez C, Llorens-Torromé S and González-Barboteo J: Efficacy and safety of methadone as a second-line opioid for cancer pain in an outpatient clinic: A prospective open-label study. Oncologist. 21:981–987. 2016. View Article : Google Scholar : PubMed/NCBI

21 

Douglas I and Bush D: The use of patient-controlled boluses of local anaesthetic via a psoas sheath catheter in the management of malignant pain. Pain. 82:105–107. 1999. View Article : Google Scholar : PubMed/NCBI

22 

Becker R, Jakob D, Uhle EI, Riegel T and Bertalanffy H: The significance of intrathecal opioid therapy for the treatment of neuropathic cancer pain conditions. Stereotact Funct Neurosurg. 75:16–26. 2000. View Article : Google Scholar : PubMed/NCBI

23 

Son BC, Yoon JH, Kim DR and Lee SW: Dorsal rhizotomy for pain from neoplastic lumbosacral plexopathy in advanced pelvic cancer. Stereotact Funct Neurosurg. 92:109–116. 2014. View Article : Google Scholar : PubMed/NCBI

24 

Nakamura K, Sasaki T, Ohga S, Yoshitake T, Terashima K, Asai K, Matsumoto K, Shioyama Y and Honda H: Recent advances in radiation oncology: Intensity-modulated radiotherapy, a clinical perspective. Int J Clin Oncol. 19:564–569. 2014. View Article : Google Scholar : PubMed/NCBI

25 

Zhang MX, Li J, Shen GP, Zou X, Xu JJ, Jiang R, You R, Hua YJ, Sun Y, Ma J, et al: Intensity-modulated radiotherapy prolongs the survival of patients with nasopharyngeal carcinoma compared with conventional two-dimensional radiotherapy: A 10-year experience with a large cohort and long follow-up. Eur J Cancer. 51:2587–2595. 2015. View Article : Google Scholar : PubMed/NCBI

Related Articles

Journal Cover

July 2018
Volume 9 Issue 1

Print ISSN: 2049-9450
Online ISSN:2049-9469

Sign up for eToc alerts

Recommend to Library

Copy and paste a formatted citation
APA
Takamatsu, S., Murakami, K., Takaya, H., Tobiume, T., Nakai, H., Suzuki, A. ... Matsumura, N. (2018). Malignant psoas syndrome associated with gynecological malignancy: Three case reports and a review of the literature. Molecular and Clinical Oncology, 9, 82-86. https://doi.org/10.3892/mco.2018.1635
MLA
Takamatsu, S., Murakami, K., Takaya, H., Tobiume, T., Nakai, H., Suzuki, A., Mandai, M., Matsumura, N."Malignant psoas syndrome associated with gynecological malignancy: Three case reports and a review of the literature". Molecular and Clinical Oncology 9.1 (2018): 82-86.
Chicago
Takamatsu, S., Murakami, K., Takaya, H., Tobiume, T., Nakai, H., Suzuki, A., Mandai, M., Matsumura, N."Malignant psoas syndrome associated with gynecological malignancy: Three case reports and a review of the literature". Molecular and Clinical Oncology 9, no. 1 (2018): 82-86. https://doi.org/10.3892/mco.2018.1635