Malignant plexopathies in palliative care

Plexopathies are often caused by local effects of tumours (eg brachial and lumbosacral plexopathy) or their treatment, and present with peripheral neurological symptoms (eg numbness), motor impairment, and neuropathic and nociceptive pain. Many patients have lymphoedema in the affected limb. Lumbosacral plexopathy can present with urinary retention and incontinence and is often related to damage of the cauda equina (although spinal cord compression] may need to be excluded).

Pain from plexopathy can be difficult to control—seek specialist palliative care advice. Interventional therapies include nerve stimulators, surgical repair, ablative procedures and nerve blocks. Epidural or intrathecal analgesia may have a role in managementRubin, 2020Saiz-Sapena N, 2019Shanina, 2019.