Endometriosis presenting like a psoas abscess

Shyamasunder N Bhat, Simanchal P Mohanty, Prahlad Kustagi
Saudi medical journal · 2007 · vol. 28(6) , pp. 952–954 · doi:10.15537/1658-3175.3947 · PMID:17530117 · W2157223465
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

A case of endometriosis in the iliopsoas muscle mimicked a psoas abscess, causing hip pain and deformity, which resolved after excision and hormonal therapy.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This case report describes a 39-year-old woman with a 5-year history of right hip pain whose CT imaging showed a multi-loculated mass in the right iliopsoas muscle that resembled a psoas abscess. Surgical exploration found a hemorrhagic cystic mass compressing the femoral nerve, and histology confirmed endometriosis. The patient then received cyclic hormonal suppressive therapy for 3 months, with complete resolution of pain and hip flexion deformity. The report cautions that retroperitoneal endometriosis can mimic a psoas abscess and that misdiagnosis may lead to inappropriate treatment, though it is limited to a single patient. This paper is centrally about endometriosis — specifically retroperitoneal iliopsoas endometriosis presenting like a psoas abscess.

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Abstract

Endometriosis is the presence of ectopic endometrial tissue that responds to hormonal stimulation. Although endometriosis occurs most often in the pelvis, several unusual sites have been reported. We present a case of endometriosis mimicking, a psoas abscess. A 39-year-old lady presented with pain around the right hip, of 5 years duration. Computed tomography CT scan showed a multi-loculated mass in the right iliopsoas muscle. On exploration, a hemorrhagic cystic mass was seen pressing on the femoral nerve. The lesion was excised and histological examination of the tissue showed features of endometriosis. The patient was treated by cyclic hormonal suppressive therapy for 3 months. Her pain and the flexion deformity of the hip resolved completely. Retroperitoneal endometriosis presenting with deformity and pain in the hip may mimic a psoas abscess. If the possibility of this diagnosis is entertained, inappropriate treatment may be avoided.
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Abstract Endometriosis is the presence of ectopic endometrial tissue that responds to hormonal stimulation. Although endometriosis occurs most often in the pelvis, several unusual sites have been reported. We present a case of endometriosis mimicking, a psoas abscess. A 39-year-old lady presented with pain around the right hip, of 5 years duration. Computed tomography CT scan showed a multi-loculated mass in the right iliopsoas muscle. On exploration, a hemorrhagic cystic mass was seen pressing on the femoral nerve. The lesion was excised and histological examination of the tissue showed features of endometriosis. The patient was treated by cyclic hormonal suppressive therapy for 3 months. Her pain and the flexion deformity of the hip resolved completely. Retroperitoneal endometriosis presenting with deformity and pain in the hip may mimic a psoas abscess. If the possibility of this diagnosis is entertained, inappropriate treatment may be avoided. Article Type Case Report First Page 952 Last Page 954 Recommended Citation Bhat, Shyamasunder N.; Mohanty, Simanchal P.; and Kustagi, Prahlad (2007) "Endometriosis presenting like a psoas abscess," Saudi Medical Journal: Vol. 28: Iss. 6, Article 25. DOI: https://doi.org/10.15537/1658-3175.3947

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Endometriosis Psoas Abscess Adult Diagnosis, Differential Endometriosis Endometriosis Female Humans Psoas Abscess Retroperitoneal Space Tomography, X-Ray Computed

Citation neighborhood

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