[Sciatica secondary to extrapelvic endometriosis affecting the piriformis muscle. Case report]

Miguel Domínguez-Páez, de Miguel-Pueyo LS, Luis Segundo de Miguel-Pueyo, Juan Manuel Medina-Imbroda, Medina-Imbroda JM, Laura González-García, González-García L, Moreno-Ramírez V, Vanessa Moreno-Ramírez, Alvaro Martín-Gallego, Álvaro Martín-Gallego, Martín-Gallego A, Mariano Socolovsky, Socolovsky M, Miguel Ángel Arráez-Sánchez, Arráez-Sánchez MÁ
Neurocirugia (Asturias, Spain) · 2012 · vol. 23(4) , pp. 170–174 · doi:10.1016/j.neucir.2012.04.009 · PMID:22728121 · W1976979824
Case report OA: closed CC0 ⤵ 5 in-corpus citations
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This case report describes a patient experiencing secondary sciatica due to extrapelvic endometriosis infiltrating the piriformis muscle.

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Abstract

OBJECTIVE: We present a case report of symptomatic compression of the right sciatic nerve notch, secondary to piriformis muscle endometriosis, as well as a literature review. MATERIAL AND METHODS: We report the case of a 29-year-old woman with 2-year evolution of right chronic sciatica. During the first year, symptoms were episodic and associated with menstruation. During the second year, sciatica was constant and associated with gait disorder due to sciatic musculature weakness. Mononeuropathy was proved by a neurophysiological study, with MRI and PET studies revealing a mass in the sciatic notch and regional pathological increase in metabolic activity. Surgical treatment was performed in order to release the nerve and obtain a histological sample. RESULTS: The patient was treated by a transgluteal approach, with external neurolysis of the sciatic nerve and resection of an old-blood cyst at the level of the piriformis muscle. This was subsequently reported as endometriosis by histological examination. The sciatica was resolved after surgery. CONCLUSIONS: Extrapelvic sciatic nerve compression by adjacent endometriosis is very infrequent. Muscle denervation and lack of a histological diagnosis led to surgical exploration of the compression area in order to release the nerve, resect the cause of compression and obtain a definitive diagnosis. The procedure improved all symptoms.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Sciatica Sciatica Female Female Humans Humans Magnetic Resonance Imaging Magnetic Resonance Imaging Nerve Compression Syndromes Nerve Compression Syndromes Sciatic Nerve Sciatic Nerve

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (25)

Cited by (6)

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