Case reports and literature review of neuro-endometriosis: beyond degenerative spine disease

Luca Pio Stoppino, Arnaldo Scardapane, Stefano Piscone, Sara Saccone, G. Schiraldi, Paola Milillo, Luca Macarini, Roberta Vinci
In: Gazzetta Medica Italiana Archivio per le Scienze Mediche · 2025 · vol. 184(7-8) · doi:10.23736/s0393-3660.25.06075-9 · W4412818306
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

This paper reports two cases of neuro-endometriosis presenting as cyclic leg pain, diagnosed via MRI and confirmed histopathologically, highlighting its consideration in women with catamenial sciatica.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-17 · read from full text ⓘ

This case report and literature review examines neuro-endometriosis, a rare manifestation where endometrial tissue invades the nervous system, using two patient cases presenting with cyclic lower back pain and sciatica-like symptoms. The authors demonstrate that pelvic magnetic resonance imaging is critical for accurate diagnosis and preoperative planning, with findings confirmed by histopathology after surgical excision. They emphasize that recognizing this condition in women of reproductive age with catamenial neurological pain is vital to prevent long-term complications and improve clinical outcomes. This paper is centrally about endometriosis — specifically its rare extrapelvic involvement affecting the nervous system and spine.

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Abstract

Endometriosis is a prevalent benign gynecological disorder affecting 10-15% of women of reproductive age, often manifesting as pelvic pain and infertility. While the pelvic peritoneum, ovaries, and rectovaginal septum are the most commonly involved sites, a less frequent but significant manifestation is neuro-endometriosis, characterized by nervous system involvement. We report two cases of neuro-endometriosis in patients presenting with cyclic lower back pain radiating to the lower limbs. Diagnosis was accurately established through pelvic magnetic resonance imaging (MRI) and subsequently confirmed by histopathological examination following surgical removal. Neuro-endometriosis should be considered in women of reproductive age experiencing sciatica-like pain with a cyclic and catamenial pattern. Transvaginal ultrasound (TV-US) and MRI are the primary imaging modalities for detecting endometriotic lesions, with MRI playing a crucial role in both diagnosis and preoperative planning. Recognizing neuro-endometriosis is essential for appropriate management, as early identification and intervention can prevent long-term neurological complications and improve patient outcomes.
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JOURNAL TOOLS | | Journal policies | | Publishing options | | eTOC | | To subscribe | | Submit an article | | Recommend to your librarian | ARTICLE TOOLS | | Publication history | | Reprints | | Permissions | | Cite this article as | | Share | YOUR ACCOUNT YOUR ORDERS SHOPPING BASKET Items: 0 Total amount: € 0,00 HOW TO ORDER YOUR SUBSCRIPTIONS YOUR ARTICLES YOUR EBOOKS COUPON ACCESSIBILITY CASE REPORT Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2025 July-August;184(7-8):704-8 DOI: 10.23736/S0393-3660.25.06075-9 Copyright © 2025 EDIZIONI MINERVA MEDICA language: English Case reports and literature review of neuro-endometriosis: beyond degenerative spine disease Luca P. STOPPINO 1, Arnaldo SCARDAPANE 2, Stefano PISCONE 1 ✉, Sara SACCONE 1, Giorgia SCHIRALDI 3, Paola MILILLO 1, Luca MACARINI 1, Roberta VINCI 1 1 Section of Diagnostic Imaging, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy; 2 Department of Experimental Medicine, University of Salento, Lecce, Italy; 3 Unit of Diagnostic and Interventional Radiology, Department of Radiology, Maggiore Polyclinic Hospital, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy Endometriosis is a prevalent benign gynecological disorder affecting 10-15% of women of reproductive age, often manifesting as pelvic pain and infertility. While the pelvic peritoneum, ovaries, and rectovaginal septum are the most commonly involved sites, a less frequent but significant manifestation is neuro-endometriosis, characterized by nervous system involvement. We report two cases of neuro-endometriosis in patients presenting with cyclic lower back pain radiating to the lower limbs. Diagnosis was accurately established through pelvic magnetic resonance imaging (MRI) and subsequently confirmed by histopathological examination following surgical removal. Neuro-endometriosis should be considered in women of reproductive age experiencing sciatica-like pain with a cyclic and catamenial pattern. Transvaginal ultrasound (TV-US) and MRI are the primary imaging modalities for detecting endometriotic lesions, with MRI playing a crucial role in both diagnosis and preoperative planning. Recognizing neuro-endometriosis is essential for appropriate management, as early identification and intervention can prevent long-term neurological complications and improve patient outcomes. KEY WORDS: Case reports; Magnetic resonance imaging; Spinal diseases; Endometriosis; Sciatic nerve

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endometriosisinfertility

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