Endometriosis causing lower extremity deep vein thrombosis — case report and review of the literature

Abstract

Endometriosis is a medical condition in women wherein endometrial cells deposited in the area outside the uterine cavity are influenced by hormonal changes, and produce symptoms depending on the site of implantation. A unique case of retroperitoneal endometriosis causing deep vein thrombosis from extrinsic compression of the right iliac vein is described. Clinical presentation with cyclical leg swelling, coincidental with menstruation and culminating with deep vein thrombosis, although very suggestive, has not been previously reported.

Thrombosis of iliac vessels, a rare complication of endometriosis: Case report and review of literature

“…The case of Rosengarten et al [4] was the first description of DVT due to endometriosis encircling the right external iliac vein. In the case described by Sharma et al [5], the disease had a retroperitoneal localization and DVT of the right common femoral vein, external iliac and distal internal iliac veins occurred. These three patients had no previous history of a DVT and presented the typical cyclic symptomatology of endometriosis, but no previous general symptoms such as episodes of abdominal and pelvic pain, menorrhagia, metrorrhagia, dyspareunia, and dysmenorrhea.…”

“…Instead, the described patient developed a sudden symptomatology, different from the cyclic catamenial edema of the other patients. In the case described by Sharma et al [5] the patient did not take any anticoagulation therapy and developed DVT. Notwithstanding Rosengarten et al [4] reported the development of DVT despite administration of appropriate medical therapy, similar to what was observed in this case.…”

“…The symptoms are often nonspecific and do not correlate with extent or severity of the disease [1], [2], [3], [4], [5]. The presented patient had a very rare localization of endometriosis and an uncommon complication, the thrombosis of iliac vessel.…”

“…A literature review of extraperitoneal endometriosis revealed varying presentations of the disease [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15]. Nevertheless, only a very limited number of cases showed involvement of iliac vessels [3], [4], [5] and only two of them had concurrent vascular complication [4], [5]. The sudden onset of symptomatology without previous associated malaise, the extension and the associated complications of the reported case was different.…”

Chronic common femoral vein occlusion secondary to endometriosis

“…10–12 It is believed that the presence of a femoral hernia allows spillage of endometrial tissue from the pelvis into the groin. Endometriosis in the groin can theoretically cause catamenial pain and mass-related symptoms.…”