Compression of the lumbosacral plexus due to a pelvic giant lipoma causingthe symptoms of sciatica.

Purpose: The aim of this study is to demonstrate the importance of the diff erential diagnosis of sciatica. Radiculopathy in the lower extremity of an adult usually originates from a herniated nucleus pulposus. In this paper a n extraspinal cause of sciatica due to a pelvic tumor is reported, which is initially often not recognized. Methods and results: A 67-year old woman s uffered from sciatica. After one year of unsuccessful conservative treatmen t and beginning weakness of hip flexion a computed tomography of the pelvis revealed a giant lipoma with compression of the lumbosacral plexus. Conclu sions: The results of this case illustrate the problem of overrating CT-fin dings of the lumbar intervertebral disks in patients with sciatica. Extrasp inal tumorous causes of radiculopathy are rare, but should be considered if the therapeutical measures are resistant to treatment. Computed tomography and magnetic resonance imaging are most useful in confirming a retroperito neal tumor causing lumbosacral radiculopathy.