Isolated Deep Infiltrating Endometriosis of the Sciatic Nerve: A Case Report and Overview of the Literature

Isolated deep infiltrating endometriosis (DIE) of sacral nerve roots or major pelvic nerves, including the sciatic nerve, is considered to be extremely rare. Due to the overlap with sciatica symptoms, the diagnosis of sciatica DIE is difficult yet crucial, as it results in permanent neural damage if...

Full description

Saved in:
Bibliographic Details
Published inMedicina (Kaunas, Lithuania) Vol. 59; no. 12; p. 2161
Main Authors Zamurovic, Milena, Tomic, Ana, Djordjevic, Katarina, Simanic, Sara, Sopta, Jelena, Rasulic, Lukas, Simic, Ljubica, Jevtic, Jovan, Nedeljkovic-Arsenovic, Olga, Rovcanin, Marija
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 01.12.2023
Subjects
Antigens
Body fat
Cytokeratin
Development and progression
Diagnosis
Endometriosis
Endometriosis - complications
Endometriosis - diagnosis
Endometriosis - pathology
Estrogens
Female
female healthcare
Gynecology
Humans
Menstruation
Middle Aged
Monoclonal antibodies
Muscle strength
outcome
Ovarian cancer
Pain
Pelvis
pharmacotherapy
Pituitary hormones
sciatic nerve
Sciatic Nerve - pathology
Sciatica - complications
Sciatica - pathology
Uterus
Womens health
Serbia
United Kingdom
United Kingdom > UK
United States > US
endometriosis
diagnosis
pharmacotherapy
outcome
female healthcare
sciatic nerve
Online AccessGet full text

Cover

More Information
Summary:Isolated deep infiltrating endometriosis (DIE) of sacral nerve roots or major pelvic nerves, including the sciatic nerve, is considered to be extremely rare. Due to the overlap with sciatica symptoms, the diagnosis of sciatica DIE is difficult yet crucial, as it results in permanent neural damage if left untreated. We report a case of a 45-year-old woman who experienced a three-year-long and recently exacerbating pain in her right leg, accompanied by a tingling sensation and weakness in her right leg and foot, with difficulty walking. In between regular menstrual bleedings, when her aforementioned symptoms worsened, she had been experiencing mild 10-day extra-cyclical bleeding. Her neurologist's, orthopedist's, and gynecological examinations were unremarkable. Magnetic resonance imaging (MRI) showed an infiltrative lesion on the right sciatic nerve that was immunohistochemically confirmed to be endometriosis. The patient was treated with gonadotropin-releasing hormone analogues (GnRHa), which led to a significantly diminished size of the lesion on the control MRI, and endometriosis remission was obtained. For persistent mild, but cyclical, pain and muscle weakness, continuous progestagnes were administered, with advice for physical therapy provided for her neuro-muscle rehabilitation and a scheduled check-up in 6 months.
ISSN:1648-9144
1010-660X
1648-9144
DOI:10.3390/medicina59122161