Endometriosis in the Lumbar Plexus Mimicking a Nerve Sheath Tumor

Sunil Jeswani, Doniel Drazin, Ali Shirzadi, Xuemo Fan, J Patrick Johnson
World journal of oncology · 2011 · vol. 2(6) , pp. 314–318 · doi:10.4021/wjon413w · PMID:29147269 · W2068466110
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This report details a case of endometriosis in the lumbar plexus mimicking a nerve sheath tumor, leading to radicular symptoms relieved by surgical resection.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 ⓘ

This paper is a case report describing a 46-year-old woman with progressive left lumbar/hip/buttock pain and radicular symptoms whose MRI showed an enhancing mass in the L4 neural foramen, initially interpreted as a nerve sheath tumor. Intraoperatively, the involved nerve had both extrinsic and intrinsic abnormalities, and pathology confirmed endometriosis. The authors report postoperative relief of radiculopathy and review prior cases, emphasizing that intraspinal endometriosis is rare and can mimic tumor-like lesions. This paper is centrally about endometriosis — specifically endometriosis in the lumbar plexus/neural foramen mimicking a nerve sheath tumor with neurologic symptoms.

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Abstract

Endometriosis consists of ectopic endometrial tissue outside of the uterine cavity. It is typically benign; however, in some cases, it may cause neurological symptoms if involving the central or peripheral nervous system. We present in this report a 46-year-old Caucasian female with lumbar pain progressively worsening for the last 3 years in her left hip and buttock with radicular symptoms radiating to her left anterior thigh with MR imaging showed an enhancing mass in the L4 neural foramen, interpreted as a nerve sheath tumor. At operation the nerve showed extrinsic and intrinsic abnormality, proven to be endometriosis. Postoperatively, the patient reported relief from her radiculopathy. We review the previous cases, discuss the pathogenesis and additional characteristics that highlight that intraspinal endometriosis, although rare, and must be considered as a potential cause of lumbar pain in women. Surgical resection is recommended in cases having severe or worsening neurologic symptoms or signs of cauda equina syndrome but care must be taken to avoid injuring the nerve. Adjunctive treatment may be used in cases of residual or recurrent lesions. World J Oncol. 2011;2(6):314-318 doi: https://doi.org/10.4021/wjon413w

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endometriosis

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