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Dominick J. H. McCabe, MB, MRCPI; Gerard P. McCarthy, MB; Finbarr Condon, FRCSI; Sean Connolly, MD; Paul Brennan, FRCR; Francesca M. Brett, FRCPath; Brian Hurson, FRCSI; Kieran Sheahan, MRCPath; Janice Redmond, MD

Arch Neurol. 2002;59:1179-1181.

Context  Although herniation of a lumbosacral intervertebral disk is a major cause of sciatic distribution pain, relentlessly progressive symptoms or signs should alert one to the possibility of a tumor involving the nerve.

Objective  To describe the clinical, neurophysiological, and histological features of a pathologically unique tumor involving the sciatic nerve.

Setting  Tertiary referral university hospital.

Patient  A 36-year-old woman was seen with a 6-year history of increasingly severe symptoms in the distribution of the left sciatic nerve.

Results  Electromyography indicated a sciatic nerve lesion in the region of the greater sciatic notch. Magnetic resonance imaging demonstrated a tumor involving the left sciatic nerve in this area. Light microscopy, electron microscopy, and immunohistochemistry results confirmed the presence of an atypical ganglion cell tumor of the sciatic nerve that exhibited prognostically conflicting clinical and histological features.

Conclusions  To our knowledge, this is the first report of an atypical ganglion cell tumor affecting the sciatic nerve, and illustrates the value of detailed neurophysiological examination in localizing the site of peripheral nerve injury to facilitate focused neuroimaging when standard investigations are uninformative. Longer follow-up is required to determine the true biologic potential of this lesion.

From the Departments of Neurology (Drs McCabe and Redmond) and Pathology (Dr Brett), St James' Hospital, the Departments of Pathology (Drs McCarthy and Sheahan), Orthopaedic Surgery (Drs Condon and Hurson), and Clinical Neurophysiology (Dr Connolly), St Vincent's University Hospital, and the Department of Neuroradiology, Beaumont Hospital (Dr Brennan), Dublin, Ireland; and the Department of Clinical Neurology, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, London, England (Dr McCabe).