Left-Sided Sciatic Nerve Endometriosis Presenting As Chronic Thigh Pain and Muscle Atrophy: A Case Report

Parviz Samadov, Kamil Aliyev, Ilhama Eldarova, Akbar Hajiyev, Emil Hasanov
In: Cureus · 2026 · vol. 18(5) , pp. e108539 · doi:10.7759/cureus.108539 · PMID:42266317 · W7160691360
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This case report details a 40-year-old woman with chronic thigh pain and muscle atrophy caused by left-sided sciatic nerve endometriosis, emphasizing the diagnostic role of MRI and prompt intervention.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 ⓘ

This case report studied a 40-year-old woman with a two-year history of progressive left thigh and pelvic pain that worsened during menstruation, along with limited mobility and muscle atrophy; clinicians used pelvic MRI plus surgical and gynecologic intervention to evaluate suspected sciatic nerve pathology. MRI showed a mass-like lesion along the left sciatic nerve at the greater sciatic foramen with a T2 hypointense rim, central heterogeneous T1 hyperintense hemorrhagic components, thickened/edematous nerve features, and denervation-associated atrophy/STIR hyperintensity in multiple adjacent muscles, with disease progression on six-month follow-up. Histopathology after combined resection confirmed deep soft-tissue endometriosis with endometrial-type glands and stroma infiltrating skeletal muscle and around nerve bundles, accompanied by chronic inflammation, hemorrhage, hemosiderin-laden macrophages, and fibrosis. The paper’s main limitation is that it is a single case report without generalizable comparative data, though postoperative follow-up was reported as showing significant symptom improvement and no residual lesions on MRI. This paper is centrally about endometriosis — it documents left sciatic nerve endometriosis presenting as catamenial sciatica with chronic thigh pain and muscle atrophy.

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Abstract

Sciatic nerve endometriosis is a rare and often underdiagnosed form of deep infiltrating endometriosis involving the lumbosacral plexus or sciatic nerve. We present the case of a 40-year-old woman with chronic left thigh and pelvic pain exacerbated during menstruation, accompanied by limited mobility. Pelvic MRI revealed a lesion along the left sciatic nerve with characteristic hemorrhagic and inflammatory features, as well as muscle atrophy indicative of chronic denervation. Combined surgical and gynecologic intervention confirmed the diagnosis and resulted in significant symptom improvement. This case highlights the importance of clinical suspicion and MRI in early diagnosis to prevent irreversible neurologic damage.

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Condition tags

endometriosisdie_deep_infiltrating

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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