Sciatic Nerve Involvement as an Unusual Presentation of Deep Endometriosis

Carrasco, Ana López; Gutiérrez, Alicia Hernández; Gutiérrez, Paula A. Hidalgo; González, Ricardo Rodríguez; Bolívar, Patricia Isabel Salas; Elio, Ramón Usandizaga; Gutiérrez, Ignacio Zapardiel; García, Javier de Santiago

doi:10.5301/jeppd.5000282

Cited by 4 publications

(5 citation statements)

References 28 publications

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“…Endometriotic lesions in the abdominal wall and the inguinal area are rare and commonly misdiagnosed [1,4]. Inguinal endometriosis is defined as the presence of endometriotic tissue in the inguinal area, which includes the inguinal canal, extraperitoneal portion of the round ligament, inguinal lymph nodes, and subcutaneous adipose tissue [1].…”

Section: Discussionmentioning

confidence: 99%

Use of Radioactive Seed Localization to Guide Removal of a Nonpalpable Endometriotic Lesion: A Case Report

Quintas

Vidal-Sicart

Salvador³

et al. 2020

Journal of Minimally Invasive Gynecology

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Extrapelvic endometriosis is a rare and usually misdiagnosed entity. Some extrapelvic endometriotic lesions are small and nonpalpable, which makes them difficult to locate and remove. Here, we report the use of radioactive seed localization to locate and guide the excision of a small, nonpalpable endometriotic lesion. A 32-year-old woman presented with disabling pain in the right inguinal area. Magnetic resonance imaging and abdominal ultrasound results showed an 11-mm nodule in the abdominal wall, in the vicinity of the groin, consistent with an endometriotic lesion. The radioactive seed was placed within the lesion with the help of ultrasonography, and excision was guided with a portable gamma camera. Complete excision of the endometriotic nodule was achieved. We propose radioactive seed localization as an accurate and feasible technique for the treatment of nonpalpable endometriotic lesions.

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Section: Discussionmentioning

confidence: 99%

Use of Radioactive Seed Localization to Guide Removal of a Nonpalpable Endometriotic Lesion: A Case Report

Quintas

Vidal-Sicart

Salvador³

et al. 2020

Journal of Minimally Invasive Gynecology

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“… Y , yes; N , no; NR , not reported; US , ultrasound; CT , computed tomography; MRI , magnetic resonance imaging; PET , positron emission tomography; CTA , computed tomography angiography; GnRH-a , gonadotropin-releasing hormone agonist; COC , combined oral contraceptives; LNG-IUS , levonorgestrel releasing intrauterine system; C , complete remission; P , partial remission; R , relapse; S , sequela # minor motor deficits persisted [ 50 ]; & permanent muscular damage on her left buttock and functional impairment [ 57 ], climbing stairs and getting up from squatting were impaired [ 59 ]; * nerve injury [ 61 ] …”

Section: Methodsmentioning

confidence: 99%

“…# minor motor deficits persisted [ 50 ]; & permanent muscular damage on her left buttock and functional impairment [ 57 ], climbing stairs and getting up from squatting were impaired [ 59 ]; * nerve injury [ 61 ]…”

Section: Methodsmentioning

confidence: 99%

“…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%

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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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“…The prompt adoption of hormone therapy to suppress gonadal function allows confirmation of the diagnosis, blocks the progression of the disease, and often avoids inappropriate neurosurgical procedures which in themselves can cause permanent neurological damage (Table 3, Ref. [93,99,100,103,[105][106][107][108][109][110][111][112][113][114][115][116][117][118][119][120][121]).…”

Section: Sciatic Nerve Endometriosismentioning

confidence: 99%

Rare extragenital endometriosis: pathogenesis and therapy

Fedele¹,

Fatta²,

Busnelli³

et al. 2022

Clin. Exp. Obstet. Gynecol.

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Background: In the context of extragenital endometriosis, the gastrointestinal, urinary tract, abdominal wall, and thorax localizations are considered relatively frequent, while the umbilical, inguinal, sciatic nerve, liver, and pancreas are instead "rare". Methods: Online searches were carried out in PubMed database of the last 20 years for these terms: extragenital endometriosis, umbilical endometriosis, inguinal endometriosis, sciatic nerve endometriosis, hepatic and pancreatic endometriosis. The following exclusion criteria were used:(1) Personal surgical history unspecified. (2) Nonspecific histological diagnosis for each type of endometriosis examined. (3) Inability to distinguish between the personal series of the author and the case reports described. (4) Proceedings of scientific meetings were not included. Tables that are easy to consult were compiled. Results: 810 titles were found among which 162 studies were selected for reading in full text and finally 114 papers were included, which met the objective of the revision. The so-called "rare" forms of extragenital endometriosis show an unsuspected frequency, an extreme variability of presentation, and uncertain treatment guidelines. Discussion: Gynecologists, general surgeons, and neurologists should be well acquainted with these pathologies to avoid confusing diagnostic paths and to set up adequate therapies.

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Sciatic Nerve Involvement as an Unusual Presentation of Deep Endometriosis

Cited by 4 publications

References 28 publications

Use of Radioactive Seed Localization to Guide Removal of a Nonpalpable Endometriotic Lesion: A Case Report

Use of Radioactive Seed Localization to Guide Removal of a Nonpalpable Endometriotic Lesion: A Case Report

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

Rare extragenital endometriosis: pathogenesis and therapy

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