The “neurologic hypothesis”: a new concept in the pathogenesis of the endometriosis?

Possover, Marc; Rhiem, Kerstin; Chiàntera, Vito

doi:10.1007/s10397-004-0070-8

Cited by 15 publications

(17 citation statements)

References 22 publications

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“…The possibility of EM tracking along the nerves as a form of spread was described by Possover et al; 37 however, such an anatomical, mechanistic explanation as the one described in the present report has not yet been postulated. We provide compelling evidence by presenting our 2 cases and the previously published case 18 that showed signs of perineural spread.…”

Section: Discussionmentioning

confidence: 47%

“…The perineural spread as a possible explanation is supported by reciprocal interactions between EM and nerves. 5,6,12,37 Not only does EM promote neurogenesis, 5 but in turn the nerves promote angiogenesis and EM growth.…”

Section: Discussionmentioning

confidence: 99%

“…Possover et al 37 were the first to propose a "neural hypothesis," describing a major role of the pelvic nervous system in EM. To support the theory, they correlated common locations of DIE with major components of the pelvic sympathetic system.…”

Section: Discussionmentioning

confidence: 99%

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Magnetic resonance imaging evidence for perineural spread of endometriosis to the lumbosacral plexus: report of 2 cases

Sousa¹,

Capek

Howe

et al. 2015

FOC

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Sciatic nerve endometriosis (EM) is a rare presentation of retroperitoneal EM. The authors present 2 cases of catamenial sciatica diagnosed as sciatic nerve EM. They propose that both cases can be explained by perineural spread of EM from the uterus to the sacral plexus along the pelvic autonomie nerves and then further distally to the sciatic nerve or proximally to the spinal nerves. This explanation is supported by MRI evidence in both cases. As a proof of concept, the authors retrieved and analyzed the original MRI studies of a case reported in the literature and found a similar pattern of spread. They believe that the imaging evidence of their institutional cases together with the outside case is a very compelling indication for perineural spread as a mechanism of EM of the nerve.

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Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 99%

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Magnetic resonance imaging evidence for perineural spread of endometriosis to the lumbosacral plexus: report of 2 cases

Sousa¹,

Capek

Howe

et al. 2015

FOC

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“…(Possover et al, 2005;Asante and Taylor, 2011;Carvalho et al, 2011). Kelm et al (2008) demonstrated that immunohistochemistry markers for autonomic nervous system (NPY and VIP) in nerve fibers from uterosacral ligaments of An adherent mass to the conus and the roots of the cauda equina.…”

Section: Perineural Spread -Supporting Evidence On Subcellular Levelmentioning

confidence: 98%

Neural involvement in endometriosis: Review of anatomic distribution and mechanisms

et al. 2015

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Endometriosis (EM) is an infrequent cause of peripheral neuropathy, most commonly sciatic. Perineural spread has recently been introduced as an alternate explanation for cases of lumbosacral or sciatic nerve EM. We performed a literature review to collect all reported cases of peripheral and central nervous system EM in search of anatomic patterns of involvement; potentially to support the perineural spread theory. If available, intraneural invasion and presence of peritoneal EM were recorded. The search revealed 83 articles describing 365 cases of somatic peripheral nervous EM and 13 cases of central nervous EM. The most frequently involved site was the sacral plexus (57%, n = 211), followed by the sciatic nerve (39%, n = 140). Other nerves were reported in significantly smaller numbers. Ninety seven percent (97%, n = 355) of peripheral nerve cases presented with pain, 20% (n = 72) reported weakness and 31% (n = 114), numbness. Thirty four percent (34%, n = 38) had solely intraneural EM of which 89% (n = 33) had no peritoneal EM (percentage based on available information). In the central nervous system, the conus medullaris and/or cauda equina constituted the majority of cases with 54% (n = 7). Apart from perineural spread, other discussed mechanisms include retrograde menstruation with peritoneal seeding, hematogenous and lymphogenous spread, stem cell implantation either hematogenously or via retrograde menstruation with subsequent EM differentiation, and coelomic or Müllerian duct metaplasia. We believe this literature review supports perineural spread as an alternate mechanism for EM of nerve, particularly the subgroup with intraneural EM and without peritoneal disease.

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“…Hyperestrogenism is a potential risk factor (5), and genetic predisposition is suggested for cases without it (5). On the other hand, the neurological hypothesis described by Possover and Anaf (6,7) correlates endometriotic implants with sympathetic nervous system distribution; this might account for our patient's case since the mid-lower rectum's location is extraperitoneal and in intimate contact with the sympathetic plexus.…”

Section: Discussionmentioning

confidence: 49%

Endometrioid adenocarcinoma in the lower rectum

Caballero¹,

Turégano²,

López-Tomassetti³

et al. 2013

Rev. esp. enferm. dig.

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The “neurologic hypothesis”: a new concept in the pathogenesis of the endometriosis?

Cited by 15 publications

References 22 publications

Magnetic resonance imaging evidence for perineural spread of endometriosis to the lumbosacral plexus: report of 2 cases

Magnetic resonance imaging evidence for perineural spread of endometriosis to the lumbosacral plexus: report of 2 cases

Neural involvement in endometriosis: Review of anatomic distribution and mechanisms

Endometrioid adenocarcinoma in the lower rectum

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