Carcinoma arising within sciatic nerve endometriosis: a case report

Abstract

Endometriosis is a common condition with significant morbidity. There have been case reports of endometrial deposits affecting the sciatic nerve. Sciatic nerve endometriosis presents with cyclical sciatica and is often difficult to diagnose as it mimics many other causes of sciatica. We report the first case of histological proven endometrial carcinoma arising in a pre-existing sciatic nerve endometriosis. This was initially managed with radiotherapy however symptoms persisted and she opted to have surgery with the aim of better symptom control and long-term prognosis.

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

“…Not all cases of sciatic endometriosis can be identified on MRI, and, frequently, further investigations are needed to rule out other potential benign and malignant etiologies. Where there is uncertainty regarding the imaging diagnosis, mainly when differentiating sciatic DIE from malignant peripheral nerve sheath tumors, CT-guided biopsy could be the diagnostic modality of choice [14]. Some authors have reported successfully using high-resolution ultrasound to diagnose endometriosis of the pelvic nerve, which could have potential benefits compared to MRI due to its availability and ease of access [27].…”

“…Endometrial and endometriotic epithelial cells also contain various cancer mutations, which may be associated with the formation of pelvic endometriosis or ovarian cancer [13]. Although exceedingly uncommon, instances of carcinoma originating from a localized area of sciatic endometriosis have been documented, exhibiting no notably distinct clinical symptoms compared to noncancerous endometriosis lesions [14], further emphasizing the importance of prompt diagnosis.…”