title: Endometriosis of the conus medullaris causing cyclic radiculopathy.
abstract: Intramedullary spinal cord hematomas are a rare neurosurgical pathological entity typically arising from vascular and neoplastic lesions. Endometriosis is an extremely rare cause of intramedullary spinal cord hematoma, with only 5 previously reported cases in the literature. Endometriosis is characterized by ectopic endometrial tissue, typically located in the female pelvic cavity, that causes a cyclical pain syndrome, bleeding, and infertility. In the rare case of intramedullary endometriosis of the spinal cord, symptoms include cyclical lower-extremity radiculopathies and voiding difficulties, and can acutely cause cauda equina syndrome. The authors report a case of endometriosis of the conus medullaris, the first to include radiological, intraoperative, and histopathological imaging. A brief review of the literature is also presented, with discussion including etiological theories surrounding intramedullary endometriosis.
authors.affiliation: Division of Neurosurgery, University of California, San Diego, California.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Steinberg
authors.forename: David D
authors.initials: DD
authors.lastname: Gonda
authors.forename: Karra
authors.initials: K
authors.lastname: Muller
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Ciacci
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004576:Electromyography; D004715:Endometriosis / Q000150:complications* / Q000473:pathology / Q000601:surgery; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D011843:Radiculopathy / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D013116:Spinal Cord; D013118:Spinal Cord Diseases / Q000209:etiology* / Q000473:pathology / Q000601:surgery
keywords: ER = estrogen receptor; LE = lower extremity; conus medullaris; endometriosis; hematoma; hemorrhage; lumbar spine; radiculopathy; spinal cord