Monofocal femoral subacute neuropathy as a key diagnostic element in a case of sigmoid neoplasm

Abstract

In this paper we present the case of a 91 years-old male patient who was admitted for motor weakness accompanied by neuropathic pain suggestive for a femoral mononeuropathy which onset and evolution was subacute – chronic. The clinical examination and laboratory investigations confirmed the diagnosis of femoral nerve mononeuropathy, but also showed others signs and symptoms suggestive for a disorder in the area in the lower digestive and urinary tracts, which finally allowed us the etiologic diagnosis of recto-sigmoid colon cancer. This case raises some problems related to the etiological differential diagnosis of a femoral nerve neuropathy which most often is not the consequence of a disco-vertebral pathology but, of other lesions located inside the pelvis as long as this nerve has its initial trajectory in the intra-abdominal region having different neighboring reports on the left and on the right side, which are also different according to the patient’s sex in particular with different segments of the lower digestive tract and in women also with the salpingian-ovarian structures. Comorbidities, in particular diabetes mellitus and also the particularities related to the patient’s age increase the complexity of the problem related to the etiological differential diagnosis.

Keywords

• femoral nerve mononeuropathy
• lower digestive tract
• rectosigmoid cancer
• diabetes mellitus