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...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/12/2161 |
| _version_ | 1797380164186800128 |
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| author | Milena Zamurovic Ana Tomic Katarina Djordjevic Sara Simanic Jelena Sopta Lukas Rasulic Ljubica Simic Jovan Jevtic Olga Nedeljkovic-Arsenovic Marija Rovcanin |
| author_facet | Milena Zamurovic Ana Tomic Katarina Djordjevic Sara Simanic Jelena Sopta Lukas Rasulic Ljubica Simic Jovan Jevtic Olga Nedeljkovic-Arsenovic Marija Rovcanin |
| author_sort | Milena Zamurovic |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-08T20:33:15Z |
| format | Article |
| id | doaj.art-f2ed8753b5f14bb6b21f64d2c310a72e |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-08T20:33:15Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-f2ed8753b5f14bb6b21f64d2c310a72e2023-12-22T14:24:00ZengMDPI AGMedicina1010-660X1648-91442023-12-015912216110.3390/medicina59122161Isolated Deep Infiltrating Endometriosis of the Sciatic Nerve: A Case Report and Overview of the LiteratureMilena Zamurovic0Ana Tomic1Katarina Djordjevic2Sara Simanic3Jelena Sopta4Lukas Rasulic5Ljubica Simic6Jovan Jevtic7Olga Nedeljkovic-Arsenovic8Marija Rovcanin9Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, SerbiaClinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, SerbiaIsolated 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.https://www.mdpi.com/1648-9144/59/12/2161female healthcareendometriosissciatic nervediagnosispharmacotherapyoutcome |
| spellingShingle | Milena Zamurovic Ana Tomic Katarina Djordjevic Sara Simanic Jelena Sopta Lukas Rasulic Ljubica Simic Jovan Jevtic Olga Nedeljkovic-Arsenovic Marija Rovcanin Isolated Deep Infiltrating Endometriosis of the Sciatic Nerve: A Case Report and Overview of the Literature Medicina female healthcare endometriosis sciatic nerve diagnosis pharmacotherapy outcome |
| title | Isolated Deep Infiltrating Endometriosis of the Sciatic Nerve: A Case Report and Overview of the Literature |
| title_full | Isolated Deep Infiltrating Endometriosis of the Sciatic Nerve: A Case Report and Overview of the Literature |
| title_fullStr | Isolated Deep Infiltrating Endometriosis of the Sciatic Nerve: A Case Report and Overview of the Literature |
| title_full_unstemmed | Isolated Deep Infiltrating Endometriosis of the Sciatic Nerve: A Case Report and Overview of the Literature |
| title_short | Isolated Deep Infiltrating Endometriosis of the Sciatic Nerve: A Case Report and Overview of the Literature |
| title_sort | isolated deep infiltrating endometriosis of the sciatic nerve a case report and overview of the literature |
| topic | female healthcare endometriosis sciatic nerve diagnosis pharmacotherapy outcome |
| url | https://www.mdpi.com/1648-9144/59/12/2161 |
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