Perineural spread of clear cell adenocarcinoma of müllerian origin resulting in neoplastic lumbosacral plexopathy.

BACKGROUND Adenocarcinomas of mullerian origin are malignancies derived from tissues of the proximal third of the vagina, cervix, uterus and fallopian tubes. These organs develop from the embryologic mullerian ducts. While reports of perineural spread of certain uterine and cervical carcinomas exist in the literature, to our knowledge, no reports of clear cell type mullerian adenocarcinoma presenting with neural invasion of the lumbosacral plexus exist in the literature. CASE DESCRIPTION A 77-year-old woman with a remote history of hysterectomy and bilateral salpingo-oopherectomy for benign disease presented for evaluation of foot drop. We present clinical, electromyographic and imaging findings of her condition, which revealed a diffuse intraneural lesion of the ipsilateral lumbosacral plexus. Percutaneous biopsy of the lesion confirmed nerve infiltrating clear cell adenocarcinoma of mullerian origin. CONCLUSIONS We present the first case of adenocarcinoma of mullerian origin with confirmed perineural spread presenting with ipsilateral lower extremity weakness. This case illustrates the importance of recognizing potential perineural spread of gynecologic malignancies to avoid delay in treatment.