| Case Report | Post-radiation Piriformis Syndrome in a Cervical Korean J Pain Vol. 23, No. 1, 2010 pISSN 2005-9159 / eISSN 2093-0569 DOI：10.3344/kjp.2010.23.1.88 Cancer Patient -A Case Report- Department of Anesthesiology and Pain Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea Sang Yoon Jeon, MD, Ho Sik Moon, MD, Yun Jung Han, MD, and Choon Ho Sung, MD The piriformis syndrome is a condition allegedly attributable to compression of the sciatic nerve by the piriformis muscle. Recently, magnetic resonance neurography and electrophysiologic study have helped to diagnose piriformis syndrome. High dose radiotherapy could induce acute and delayed muscle damage. We had experienced piriformis syndrome with fatty atrophy of piriformis muscle after radiotherapy for recurrent cervical cancer. (Korean J Pain 2010; 23: 88-91) Key Words: cervical cancer, piriformis atrophy, piriformis syndrome, postradiation neuropathy, sciatic neuropathy. 　　Piriformis syndrome, the neuropathy caused by com- pression or entrapment of sciatic nerve due to pathologic condition and anatomical variation of piriformis muscle, is CASE REPORT 　　A 50-year old female patient visited the hospital, re- difficult to differentially diagnose from discitis, lumbosacral ferred from the obstetrics and gynecology department, plexopathy, sacroiliitis, sciatica, and greater trochanteric with the chief complaints of pain at the right hip and leg bursitis [1]. It has been reported that about 6% of chronic which had continued from five to six months ago. The back pain patients has such piriformis syndrome [2]. strength of the pain was around 6/10 by visual analogue Though muscle and nerve tissue have resistance against scale (VAS). The pattern of the pain was an ache spreading radiotherapy, peripheral neuropathy including damage on from the right part of the anus to the right thigh and the muscle tissue can occur in low probability [3]. Here we re- rear side of the calf. She felt the pain in all types of posi- port a case where peripheral neuropathy is caused by tions, but it was even more serious when she sat or walked damage on muscle tissue after radiotherapy for a cervical for a long time. Physical examination, including the sen- cancer patient. sory and motor neurologic test, deep tendon reflex test, straight leg raise test, and flexion, adduction and internal Received November 4, 2009. Revised November 25, 2009. Accepted December 22, 2009. Correspondence to: Choon Ho Sung, MD Department of Anesthesiology and Pain Medicine, St. Mary's Hospital, The Catholic University of Korea College of Medicine, 62, Yeouido-dong, Yeongdeungpo-gu, Seoul 150-896, Korea Tel: ＋82-2-3779-1268, Fax: ＋82-2-783-0368, E-mail: chsung@catholic.ac.kr This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright ⓒ The Korean Pain Society, 2010