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

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

Endometriosis in the Lumbar Plexus Mimicking a Nerve Sheath Tumor


Figure 1.
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.
Figure 2. Postoperative T1 sagittal (right) and axial (left) MRI with contrast demonstrating resection of the nerve root sheath tumor.
Figure 3.
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, YearAgeClinical presentationLocationTreatmentAdjunctive treatmentOutcome
Agarwal et al, 200640Back pain –menstrual, weakness, incontinenceL1-2, IntraduralBilateral laminectomyDanazol, Bilateral oopherectomyPain free. No recurrence
Carta et. al., 199235Episodic back and left thigh painL3 foramen, ExtraduralBilateral laminectomy, foraminotomy on left sideRecurrence, treated with LH-RH drugPain free after retreatment
Erbayraktra et al., 200228Cyclic low back and groin pain, sphincter disturbanceConus, IntraduralLaminectomyGnRH therapy postoperatively. Recurrence, treated with repeat laminectomy and oophorectomyResolution of sphincter disturbance and back pain
Gortzen et al., 199538Back pain, recurrent monoparesis of left leg, cyclical leg painT8-9, only visible during menstruationGnRH analog as primary treatmentNoneSymptom free without neurological deficit
Lombardo et al., 196826Radicular pain, repeated subarachnoid hemorrhagesL1-2 nerve roots, IntraduralLaminectomyRecurrence, treated with ChlorprogesteroneOccasional pain, no further subarachnoid hemorrhage
Sun et al., 200227Cyclic lumbosacral and radicular pain, leg weakness, dysuriaL3-4, IntraduralLaminectomyDanazol postoperativelyPain free, no recurrence
Present case46Radicular painL4-5 nerve root, IntraduralHemilaminectomyNonePain free, no recurrence