Intramedullary endometriosis of the conus medullaris: case report

Neurosurgery. 2006 Aug;59(2):E428; discussion E428. doi: 10.1227/01.NEU.0000223375.23617.DC.

Abstract

Objective: Intraspinal endometriosis is an extremely rare condition with characteristic symptoms, including lower back pain that increases in severity during each menstrual cycle.

Methods: Here, we report a case of endometriosis involving the conus cauda region. This patient presented with acute deterioration secondary to hemorrhage. We also review the relevant literature.

Results: Magnetic resonance imaging scans of the dorsolumbar region showed a mass lesion within the spinal canal at the L1-L2 level with evidence of acute hemorrhage. The patient underwent an emergency D12-L2 laminectomy and microdecompression of the lesion. The histological and immunohistochemical features were characteristic of intraspinal endometriosis.

Conclusion: Intraspinal endometriosis must be recognized as a potential cause of periodic neurological signs and symptoms in young and middle-aged women.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / metabolism
  • Decompression, Surgical
  • Endometriosis / complications*
  • Endometriosis / diagnosis
  • Endometriosis / physiopathology
  • Endometrium / metabolism
  • Endometrium / pathology
  • Endometrium / physiopathology
  • Female
  • Hematoma, Epidural, Spinal / etiology*
  • Hematoma, Epidural, Spinal / physiopathology
  • Hematoma, Epidural, Spinal / surgery
  • Humans
  • Laminectomy
  • Low Back Pain / diagnosis
  • Low Back Pain / etiology
  • Low Back Pain / physiopathology
  • Lumbar Vertebrae / pathology
  • Lumbar Vertebrae / surgery
  • Magnetic Resonance Imaging
  • Paraparesis / diagnosis
  • Paraparesis / etiology
  • Paraparesis / physiopathology
  • Receptors, Progesterone / analysis
  • Receptors, Progesterone / metabolism
  • Sensation Disorders / diagnosis
  • Sensation Disorders / etiology
  • Sensation Disorders / physiopathology
  • Spinal Canal / pathology*
  • Spinal Canal / physiopathology
  • Spinal Canal / surgery
  • Spinal Cord / pathology*
  • Spinal Cord / physiopathology
  • Spinal Cord Compression / diagnosis
  • Spinal Cord Compression / etiology*
  • Spinal Cord Compression / physiopathology
  • Treatment Outcome
  • Urinary Bladder, Neurogenic / diagnosis
  • Urinary Bladder, Neurogenic / etiology
  • Urinary Bladder, Neurogenic / physiopathology

Substances

  • Biomarkers, Tumor
  • Receptors, Progesterone