Endometriosis involving the sciatic nerve: A case report of isolated endometriosis of the sciatic nerve and review of the literature

Abstract

Endometriosis is a common gynecological condition which affects 5–10% of women of reproductive age and up to 50% of women with pelvic pain and infertility. The most commonly affected areas are the pelvic peritoneum, ovaries and rectovaginal septum. Isolated endometriosis of the sciatic nerve is very rare. Our patient suffered from worsening right hip and buttock pain with severe exacerbation during menstruation. Several different imaging modalities (ultrasound of her pelvis and right hip, as well as X-rays and computed tomography scans of her right hip and lumbosacral spine) failed to identify any pathology. Magnetic resonance imaging scans of her pelvis revealed a 3.5 cm endometriotic lesion over the pelvic segment of her right sciatic nerve. Following a multidisciplinary discussion, the patient underwent laparoscopic excision of endometriosis. The patient recovered well from her surgery. She successfully conceived with in vitro fertilization 3 years after her surgery, following a failed course of Clomid (Clomiphene citrate) for ovulatory dysfunction.

Carcinoma arising within sciatic nerve endometriosis: a case report

“…Isolated sciatic nerve endometriosis has also been reported. One such report is in a 24-year-old with right sciatic nerve endometriosis treated laparoscopically [ 10 ]. An example of a left sciatic nerve endometriosis is that reported in a 25-year-old with a history of constant pain in the thigh of 2 months prior to presenting to her GP.…”

“…Symptoms of sciatic nerve endometriosis might persist even with control of pelvic endometriosis. The use of medical treatment has been demonstrated to be unsuccessful in controlling symptoms of sciatica in sciatic nerve endometriosis [ 2 , 10 ]. The previously reported sciatic nerve endometrial stromal sarcoma was extensive, with tumour extension to bowel and bladder and hence surgically unrespectable.…”

“…The patient in our report had a resectable tumour with symptoms that did not improve with radiotherapy, and hence surgery offered the best chance of cure and symptom control. Furthermore, in the presence of features of nerve damage, surgery is the preferred option [ 10 ].…”

Endometriosis con infiltración aislada del nervio ciático, una forma de presentación atípica. Reporte de un caso clínico

“…8,9 La infiltración de este último, comúnmente ocurre por extensión directa a través de la pared pélvica lateral desde el septum recto-vaginal profundo. De manera aún más infrecuente, el compromiso del nervio ciático puede ser aislado, sin otros focos de endometriosis en la cavidad pelvica 10,11 .…”

Sciatic endometriosis: A narrative review of an unusual neurogynecologic condition

“…4–6 In some instances, endometriosis over the sciatic nerve will be present in isolation without apparent endometriosis in the pelvic cavity. 7 Sciatica is defined as sciatic nerve-sourced pain, which is usually is experienced in the back, buttocks, the hips, and radiates to the leg. The symptoms can vary depending upon which zone of the sciatic nerve is affected.…”