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Sequential imaging of intraneural sciatic nerve endometriosis provides insight into symptoms of cyclical sciatica

S. Capek, KK. Amrami, BM. Howe, MS. Collins, P. Sandroni, JC. Cheville, RJ. Spinner,

. 2016 ; 158 (3) : 507-12; discussion 512. [pub] 20160107

Language English Country Austria

Document type Case Reports, Journal Article

Endometriosis of the nerve often remains an elusive diagnosis. We report the first case of intraneural lumbosacral plexus endometriosis with sequential imaging at different phases of the menstrual cycle: during the luteal phase and menstruation. Compared to the first examination, the examination performed during the patient's period revealed the lumbosacral plexus larger and hyperintense on T2-weighted imaging. The intraneural endometriosis cyst was also larger and showed recent hemorrhage. Additionally, this case represents another example of perineural spread of endometriosis from the uterus to the lumbosacral plexus along the autonomic nerves and then distally to the sciatic nerve and proximally to the spinal nerves.

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$a Capek, Stepan $u Department of Neurosurgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. stepan.capek@gmail.com. 2nd Faculty of Medicine, Charles University in Prague, V Uvalu 84, 150 06, Prague 5, Czech Republic. stepan.capek@gmail.com.
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$a Endometriosis of the nerve often remains an elusive diagnosis. We report the first case of intraneural lumbosacral plexus endometriosis with sequential imaging at different phases of the menstrual cycle: during the luteal phase and menstruation. Compared to the first examination, the examination performed during the patient's period revealed the lumbosacral plexus larger and hyperintense on T2-weighted imaging. The intraneural endometriosis cyst was also larger and showed recent hemorrhage. Additionally, this case represents another example of perineural spread of endometriosis from the uterus to the lumbosacral plexus along the autonomic nerves and then distally to the sciatic nerve and proximally to the spinal nerves.
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$a Amrami, Kimberly K $u Department of Radiology, Mayo Clinic, 200 First Street, Rochester, MN, 55905, USA. amrami.kimberly@mayo.edu. $7 gn_A_00005748
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$a Howe, Benjamin M $u Department of Radiology, Mayo Clinic, 200 First Street, Rochester, MN, 55905, USA. howe.benjamin@mayo.edu.
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$a Collins, Mark S $u Department of Radiology, Mayo Clinic, 200 First Street, Rochester, MN, 55905, USA. collins.mark@mayo.edu.
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$a Sandroni, Paola $u Department of Neurology, Mayo Clinic, 200 First Street, Rochester, MN, 55905, USA. psandroni@mayo.edu.
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$a Cheville, John C $u Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street, Rochester, MN, 55905, USA. cheville.john@mayo.edu.
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$a Spinner, Robert J $u Department of Neurosurgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. spinner.robert@mayo.edu.
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