Endometriosis in the deltoid muscle: a case report

Nagamoto, Yukitaka; Hashimoto, Nobuyuki; Kakunaga, Shigeki; Ueda, Takafumi; Tomita, Yoshihiro; Yoshikawa, Hideki

doi:10.1007/s00590-011-0851-5

Cited by 5 publications

(3 citation statements)

References 14 publications

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“…Extrapelvic musculoskeletal endometriosis has been rarely described (3)(4)(5)(6)(7)(8)(9). To our knowledge, this is the first case of musculoskeletal endometriosis in the lower limb to present following a history of pelvic fracture, prompting consideration of possible pathophysiologic mechanisms.…”

Section: Discussionmentioning

confidence: 92%

“…Furthermore, MR imaging appearance of musculoskeletal endometriosis is variable as endometriosis tissue undergoes cyclic degeneration, and proliferation and appearance may change based on lesion age. Reported cases describe both hypointensity ( 4 , 5 ) and hyperintensity ( 6 , 7 ) on T2 weighted MR images. Preventing delay in treatment requires an index of suspicion and knowledge of presenting symptoms as excisional biopsy may be required for definitive diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Case Report: Extrapelvic Endometriosis in the Medial Thigh

Pascoal

Rogers

Leonardi

et al. 2021

Front. Reprod. Health

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Extrapelvic endometriosis, although rare, can present in the musculoskeletal system of reproductive-age women and cause significant pain and morbidity. The pathophysiology of this disease is not well understood. In this study, we described the case of a 39-year-old women with an inner-thigh mass causing catamenial pain. Core-biopsy of the mass confirmed endometriosis and she was referred to minimally-invasive gynecology for management. Surgical excision was performed by a multidisciplinary team and she remains pain-free postoperatively on hormonal therapy. Unique to this case, the patient had a history of pelvic fracture. Through this case report, we discuss possible pathophysiologic mechanisms of extrapelvic musculoskeletal endometriosis including the stem/progenitor cell theory and the role that musculoskeletal trauma may have in the development of this condition. Gynecologists play an important role in the recognition, diagnosis, and management of musculoskeletal endometriosis.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Case Report: Extrapelvic Endometriosis in the Medial Thigh

Pascoal

Rogers

Leonardi

et al. 2021

Front. Reprod. Health

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“…Endometriosis of the skeletal muscular system (ESMS) is defined as the presence of endometrial glands or stromal cells in skeletal muscles, bones, or joints. To date, beyond the head muscles, cases with ESMS have been reported in the trunk muscles, extremities muscles, pelvis muscles, and limb joints, including the trapezius muscle [ 9 ], deltoid muscle [ 10 , 11 ], rectus abdominis [ 12 – 39 ], obliquus externus abdominis [ 40 , 41 ], pyramidalis [ 42 ], psoas major muscle and iliopsoas muscle [ 43 – 47 ], piriformis muscle [ 48 – 51 ], internal obturator muscle [ 52 , 53 ], gluteus muscle [ 54 – 59 ], Levator ani and coccygeus [ 60 , 61 ], vastus lateralis muscle [ 62 – 65 ], thigh adductor muscle and gracilis [ 66 ], biceps femoris muscle [ 67 , 68 ], soleus and gastrocnemius [ 69 ], shoulder joint [ 70 ], wrist joint [ 71 ], and knee joint [ 72 , 73 ]. ESMS has highly variable manifestations due to the heterogeneity of lesion location; the symptoms are usually atypical, the pain is often not proportional to the size of the lesion, and sometimes ESMS does not coexist with pelvic endometriosis, which may lead to misdiagnosis or delayed diagnosis, prolonged therapy, or impaired function of the patients [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Endometriosis of the skeletal muscular system (ESMS): a systematic review

Shen

Quan

et al. 2023

BMC Women's Health

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Background Extrapelvic endometriosis occurring at skeletal muscle and joint sites is not rare and is prone to delayed diagnosis and inappropriate treatment. Herein, endometriosis of the skeletal muscular system (ESMS) is systematically reviewed to facilitate early diagnosis and treatment. Methods Literature on ESMS published before March 2022 was retrieved from the Ovid Medline and Web of Science databases, and the major clinical data were extracted for descriptive analysis. Results A total of 62 studies (78 ESMS cases) met these requirements. The ESMS included the abdominal muscles (50.7%), pelvic floor muscles (11.6%), lower limb muscles (11.6%), hip muscles (8.7%), lumbar muscles (7.2%), joints (5.8%), upper limb muscles (2.9%), and shoulder–neck muscles (1.4%). The age was 34.0 ± 7.2 years (range 17–49 years). Approximately 63.8% of patients had at least one previous pelvic surgery, and 76.8% of local symptoms were related to the menstrual cycle. The course of disease was 29.6 ± 25.4 months (range 0.5–96 months). Only 30.3% of the patients sought initial medical advice from gynecologists, while 69.7% sought initial medical advice from a nongynecological physician. Twenty-seven patients underwent fine-needle aspiration (FNA) under ultrasound or CT monitoring, and only 44.4% (12/27) were confirmed to have endometriosis by FNA tissue pathology. Approximately 47.4% (37/78) of the patients had a normal pelvic cavity appearance. Surgical resection was performed in 92.3% (72/78) of the patients, of whom 88.9% (64/72) underwent complete resection of the lesion (negative surgical margin) and 20.8% (15/72) received postoperative hormone therapy. At 16.7 months of follow-up, 83.3%, 13.8%, 2.9%, and four patients had complete response, partial response, recurrence, and permanent function impairment, respectively. Conclusion Endometriosis can occur at almost any site in the musculoskeletal system. For women of reproductive age with catamenial pain or a mass in the musculoskeletal system, endometriosis should be suspected. Fine-needle aspiration can easily lead to missed diagnoses. Surgical resection for negative margins is the main treatment, and permanent impairment of function may occur in a few patients due to delayed diagnosis. Vascular lymphatic metastasis is the most likely mechanism of pathogenesis.

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Intramuscular endometriosis of the forearm: a case report

Smith,

He,

Adhya

et al. 2024

Skeletal Radiol

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Endometriosis is a disorder that commonly affects females of reproductive age and is defined as the presence of endometrial glands or stroma outside the uterine cavity. Patients typically present with cyclical pain during menses. Endometriosis can be characterized as endopelvic or extrapelvic depending on the sites involved. We report a case of a 40-year-old, right-hand-dominant, female who presented with a painful mass in her right proximal forearm. She was ultimately diagnosed with intramuscular endometriosis and underwent surgical excision.

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Endometriosis in the deltoid muscle: a case report

Cited by 5 publications

References 14 publications

Case Report: Extrapelvic Endometriosis in the Medial Thigh

Case Report: Extrapelvic Endometriosis in the Medial Thigh

Endometriosis of the skeletal muscular system (ESMS): a systematic review

Intramuscular endometriosis of the forearm: a case report

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