Magnetic resonance imaging evidence for perineural spread of endometriosis to the lumbosacral plexus: report of 2 cases.
Sciatic nerve endometriosis (EM) is a rare presentation of retroperitoneal EM. The authors present 2 cases of catamenial sciatica diagnosed as sciatic nerve EM. They propose that both cases can be explained by perineural spread of EM from the uterus to the sacral plexus along the pelvic autonomie nerves and then further distally to the sciatic nerve or proximally to the spinal nerves. This explanation is supported by MRI evidence in both cases. As a proof of concept, the authors retrieved and analyzed the original MRI studies of a case reported in the literature and found a similar pattern of spread. They believe that the imaging evidence of their institutional cases together with the outside case is a very compelling indication for perineural spread as a mechanism of EM of the nerve.
Departments of 1 Neurosurgery.
Ana C
AC
Siquara de Sousa
Departments of 1 Neurosurgery.|International Clinical Research Center, St. Anne's University Hospital Brno, Czech Republic.
Stepan
S
Capek
Radiology, and.
Benjamin M
BM
Howe
Anatomic Pathology, Mayo Clinic, Rochester, Minnesota;
Mark E
ME
Jentoft
Radiology, and.
Kimberly K
KK
Amrami
Departments of 1 Neurosurgery.
Robert J
RJ
Spinner
D000328:Adult; D004576:Electromyography; D004715:Endometriosis / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008160:Lumbosacral Plexus / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009460:Neurologic Examination; D014057:Tomography, X-Ray Computed
DIE = deep infiltrating endometriosis; EM = endometriosis; IHP = inferior hypogastric plexus; LSP = lumbosacral plexus; autonomie pathways; endometriosis; magnetic resonance imaging; sciatic nerve; sciatica