Pulsed radiofrequency lesioning of the lumbosacral dorsal root ganglion in a patient with lumbosacral plexopathy due to locally advanced pelvic liposarcoma

Abstract

Neoplastic lumbosacral plexopathy can be associated with pelvic malignancies where patients present with severe lumbosacral radicular pain (LSP) involving the lower extremities, leading to weakness of the affected limb. We hereby report the case of a 34-year male who presented with pain in low back radiating to left lower limb for the past 2 months. MR imaging, histopathological examination after debulking surgery confirmed it as a liposarcoma involving the anterior aspect of the left side of sacrum extending toward left neural foramina of S1-S2, left greater sciatic notch and left piriformis muscle. As the LSP was refractory to previous neuropathic medications it was planned to perform pulsed radiofrequency lesioning (PRFL) of lumbosacral Dorsal root ganglion (DRG) from L3 to S1 before further oncological management. Each DRG was treated with PRFL at 42°C for 120 s. Postprocedure, the patient had a satisfactory pain relief and underwent further oncological management.