World J Oncol

World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access

Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc

Journal website http://www.wjon.org

Case Report

Volume 2, Number 6, December 2011, pages 314-318

Endometriosis in the Lumbar Plexus Mimicking a Nerve Sheath Tumor

Figure 1. Preoperative T1 sagittal (right) and axial (left) MRI with contrast showed a variable enhancing lesion with possible fluid levels in a multilobulated lesion of the left L4 neural foramen.

Figure 2. Postoperative T1 sagittal (right) and axial (left) MRI with contrast demonstrating resection of the nerve root sheath tumor.

Figure 3. Bland-appearing endometrial glands with associated endometrial stroma and adjacent dense fibrous tissue in medium-power photomicrograph (original magnification, ×10; hematoxylin-eosin stain, a), and in high-power photomicrograph (original magnification, ×40; hematoxylin-eosin stain, b).

**Table 1.** Diagnostic Findings in 7 Patients (Including the Present Case) Reported in the Literature, Including the Clinical Presentation, Location, Treatment and Outcome
Reference, Year	Age	Clinical presentation	Location	Treatment	Adjunctive treatment	Outcome
Agarwal et al, 2006	40	Back pain –menstrual, weakness, incontinence	L1-2, Intradural	Bilateral laminectomy	Danazol, Bilateral oopherectomy	Pain free. No recurrence
Carta et. al., 1992	35	Episodic back and left thigh pain	L3 foramen, Extradural	Bilateral laminectomy, foraminotomy on left side	Recurrence, treated with LH-RH drug	Pain free after retreatment
Erbayraktra et al., 2002	28	Cyclic low back and groin pain, sphincter disturbance	Conus, Intradural	Laminectomy	GnRH therapy postoperatively. Recurrence, treated with repeat laminectomy and oophorectomy	Resolution of sphincter disturbance and back pain
Gortzen et al., 1995	38	Back pain, recurrent monoparesis of left leg, cyclical leg pain	T8-9, only visible during menstruation	GnRH analog as primary treatment	None	Symptom free without neurological deficit
Lombardo et al., 1968	26	Radicular pain, repeated subarachnoid hemorrhages	L1-2 nerve roots, Intradural	Laminectomy	Recurrence, treated with Chlorprogesterone	Occasional pain, no further subarachnoid hemorrhage
Sun et al., 2002	27	Cyclic lumbosacral and radicular pain, leg weakness, dysuria	L3-4, Intradural	Laminectomy	Danazol postoperatively	Pain free, no recurrence
Present case	46	Radicular pain	L4-5 nerve root, Intradural	Hemilaminectomy	None	Pain free, no recurrence

Table 1. Diagnostic Findings in 7 Patients (Including the Present Case) Reported in the Literature, Including the Clinical Presentation, Location, Treatment and Outcome

Reference, Year

Age

Clinical presentation

Location

Treatment

Adjunctive treatment

Outcome

Agarwal et al, 2006

Back pain –menstrual, weakness, incontinence

L1-2, Intradural

Bilateral laminectomy

Danazol, Bilateral oopherectomy

Pain free. No recurrence

Carta et. al., 1992

Episodic back and left thigh pain

L3 foramen, Extradural

Bilateral laminectomy, foraminotomy on left side

Recurrence, treated with LH-RH drug

Pain free after retreatment

Erbayraktra et al., 2002

Cyclic low back and groin pain, sphincter disturbance

Conus, Intradural

Laminectomy

GnRH therapy postoperatively. Recurrence, treated with repeat laminectomy and oophorectomy

Resolution of sphincter disturbance and back pain

Gortzen et al., 1995

Back pain, recurrent monoparesis of left leg, cyclical leg pain

T8-9, only visible during menstruation

GnRH analog as primary treatment

None

Symptom free without neurological deficit

Lombardo et al., 1968

Radicular pain, repeated subarachnoid hemorrhages

L1-2 nerve roots, Intradural

Laminectomy

Recurrence, treated with Chlorprogesterone

Occasional pain, no further subarachnoid hemorrhage

Sun et al., 2002

Cyclic lumbosacral and radicular pain, leg weakness, dysuria

L3-4, Intradural

Laminectomy

Danazol postoperatively

Pain free, no recurrence

Present case

Radicular pain

L4-5 nerve root, Intradural

Hemilaminectomy

None

Pain free, no recurrence