Case Report: Extrapelvic Endometriosis in the Medial Thigh

Abstract

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.

A case of rectal endometriosis misdiagnosed as rectal malignancy on three colonoscopies and biopsies sharing a combined literature review

“…Intestinal endometriosis refers to the infiltration of endometrial glands and stroma from the plasma layer of the intestinal canal to at least the subplasma adipose tissue, whereas colorectal endometriosis is often located in the subplasma and intrinsic muscular layer, with possible involvement of the submucosal layer, but lesions involving the mucosal layer are relatively rare [5]. The exact prevalence is not known, but some retrospective studies have shown that intestinal involvement in patients with endometriosis ranges from 5.3% to 12%, with the sigmoid colon and rectum being the most frequently involved sites in the GI tract [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28], accounting for 50%-70% [29]. Also in general, ectopic endometrial tissue in the rectum is usually located in the muscular layer and rarely in the submucosa, and the rectal mucosa is usually not involved [30].…”