{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T20:41:44Z","timestamp":1792701704871,"version":"4.5.0"},"reference-count":37,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T00:00:00Z","timestamp":1702425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Isolated deep infiltrating endometriosis (DIE) of sacral nerve roots or major pelvic nerves, including the sciatic nerve, is considered to be extremely rare. Due to the overlap with sciatica symptoms, the diagnosis of sciatica DIE is difficult yet crucial, as it results in permanent neural damage if left untreated. We report a case of a 45-year-old woman who experienced a three-year-long and recently exacerbating pain in her right leg, accompanied by a tingling sensation and weakness in her right leg and foot, with difficulty walking. In between regular menstrual bleedings, when her aforementioned symptoms worsened, she had been experiencing mild 10-day extra-cyclical bleeding. Her neurologist\u2019s, orthopedist\u2019s, and gynecological examinations were unremarkable. Magnetic resonance imaging (MRI) showed an infiltrative lesion on the right sciatic nerve that was immunohistochemically confirmed to be endometriosis. The patient was treated with gonadotropin-releasing hormone analogues (GnRHa), which led to a significantly diminished size of the lesion on the control MRI, and endometriosis remission was obtained. For persistent mild, but cyclical, pain and muscle weakness, continuous progestagnes were administered, with advice for physical therapy provided for her neuro-muscle rehabilitation and a scheduled check-up in 6 months.<\/jats:p>","DOI":"10.3390\/medicina59122161","type":"journal-article","created":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T08:55:16Z","timestamp":1702457716000},"page":"2161","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Isolated Deep Infiltrating Endometriosis of the Sciatic Nerve: A Case Report and Overview of the Literature"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5850-453X","authenticated-orcid":false,"given":"Milena","family":"Zamurovic","sequence":"first","affiliation":[{"name":"Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4212-0182","authenticated-orcid":false,"given":"Ana","family":"Tomic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia"},{"name":"University Clinical Center of Serbia, Center for Radiology and Magnetic Resonance Imaging, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2146-4861","authenticated-orcid":false,"given":"Katarina","family":"Djordjevic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Simanic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelena","family":"Sopta","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia"},{"name":"Department for Pathology, Faculty of Medicine, University of Belgrade, Dr Subotica 4\/2, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Rasulic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia"},{"name":"Department of Peripheral Nerve Surgery, Functional Neurosurgery and Pain Management Surgery, Clinic for Neurosurgery, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Dr Koste Todorovica 4, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ljubica","family":"Simic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia"},{"name":"Department for Pathology, Faculty of Medicine, University of Belgrade, Dr Subotica 4\/2, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3424-4623","authenticated-orcid":false,"given":"Jovan","family":"Jevtic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia"},{"name":"Department for Pathology, Faculty of Medicine, University of Belgrade, Dr Subotica 4\/2, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Nedeljkovic-Arsenovic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia"},{"name":"University Clinical Center of Serbia, Center for Radiology and Magnetic Resonance Imaging, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marija","family":"Rovcanin","sequence":"additional","affiliation":[{"name":"Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1056\/NEJMra1810764","article-title":"Endometriosis","volume":"382","author":"Zondervan","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1007\/s13669-017-0187-1","article-title":"Endometriosis: Epidemiology, Diagnosis and Clinical Management","volume":"6","author":"Parasar","year":"2017","journal-title":"Curr. Obstet. Gynecol. Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1111\/1471-0528.16447","article-title":"Prevalence and Incidence of Endometriosis in Australian Women: A Data Linkage Cohort Study","volume":"128","author":"Rowlands","year":"2021","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1038\/s41574-019-0245-z","article-title":"Rethinking Mechanisms, Diagnosis and Management of Endometriosis","volume":"15","author":"Chapron","year":"2019","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1016\/S0140-6736(21)00389-5","article-title":"Endometriosis Is a Chronic Systemic Disease: Clinical Challenges and Novel Innovations","volume":"397","author":"Taylor","year":"2021","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1016\/j.fertnstert.2022.07.024","article-title":"Prevalence of Endometrioma and Deep Infiltrating Endometriosis at Transvaginal Ultrasound Examination of Subfertile Women Undergoing Assisted Reproductive Treatment","volume":"118","author":"Alson","year":"2022","journal-title":"Fertil. Steril."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1016\/j.fertnstert.2010.08.048","article-title":"Laparoscopic Therapy for Endometriosis and Vascular Entrapment of Sacral Plexus","volume":"95","author":"Possover","year":"2011","journal-title":"Fertil. Steril."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"369","DOI":"10.52054\/FVVO.13.4.047","article-title":"Laparoscopic Morphological Aspects and Tentative Explanation of the Aetiopathogenesis of Isolated Endometriosis of the Sciatic Nerve: A Review Based on 267 Patients","volume":"13","author":"Possover","year":"2021","journal-title":"Facts Views Vis. ObGyn"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1212\/WNL.36.10.1360","article-title":"Sciatic Endometriosis: A Treatable Sensorimotor Mononeuropathy","volume":"36","author":"Roos","year":"1986","journal-title":"Neurology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1470","DOI":"10.1007\/s00415-011-6378-1","article-title":"Sciatic Endometriosis Presenting as Periodic (Catamenial) Sciatic Radiculopathy","volume":"259","author":"Ghezzi","year":"2012","journal-title":"J. Neurol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e17","DOI":"10.1016\/j.fertnstert.2006.05.084","article-title":"Isolated Infiltrative Endometriosis of the Sciatic Nerve: A Report of Three Patients","volume":"87","author":"Possover","year":"2007","journal-title":"Fertil. Steril."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1093\/humrep\/dey015","article-title":"Fibrogenesis Resulting from Cyclic Bleeding: The Holy Grail of the Natural History of Ectopic Endometrium","volume":"33","author":"Guo","year":"2018","journal-title":"Hum. Reprod. Oxf. Engl."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1210\/er.2018-00242","article-title":"Endometriosis","volume":"40","author":"Bulun","year":"2019","journal-title":"Endocr. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"rjab512","DOI":"10.1093\/jscr\/rjab512","article-title":"Carcinoma Arising within Sciatic Nerve Endometriosis: A Case Report","volume":"2021","author":"Yahaya","year":"2021","journal-title":"J. Surg. Case Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1002\/jcp.22888","article-title":"Embryologic Origin of Endometriosis: Analysis of 101 Human Female Fetuses","volume":"227","author":"Signorile","year":"2012","journal-title":"J. Cell. Physiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1002\/stem.2804","article-title":"Hematogenous Dissemination of Mesenchymal Stem Cells from Endometriosis","volume":"36","author":"Li","year":"2018","journal-title":"Stem Cells Dayt. Ohio"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Ye, H., Shen, C., Quan, Q., Xi, M., and Li, L. (2023). Endometriosis of the Skeletal Muscular System (ESMS): A Systematic Review. BMC Womens Health, 23.","DOI":"10.1186\/s12905-023-02184-8"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1097\/00006250-200308000-00029","article-title":"Evidence for Asymmetric Distribution of Sciatic Nerve Endometriosis","volume":"102","author":"Vercellini","year":"2003","journal-title":"Obstet. Gynecol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1590\/S0004-282X2011000700032","article-title":"Endometriosis of the Sciatic Nerve","volume":"69","author":"Teixeira","year":"2011","journal-title":"Arq. Neuropsiquiatr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1146\/annurev-physiol-012110-142158","article-title":"Endometriosis: The Role of Neuroangiogenesis","volume":"73","author":"Asante","year":"2011","journal-title":"Annu. Rev. Physiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e00515","DOI":"10.1016\/j.crwh.2023.e00515","article-title":"Sciatic Nerve Endometriosis\u2014The Correct Approach Matters: A Case Report","volume":"38","author":"Bindra","year":"2023","journal-title":"Case Rep. Womens Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1302\/0301-620X.90B1.19832","article-title":"Cyclical sciatica: Endometriosis of the sciatic nerve","volume":"90","author":"Mannan","year":"2008","journal-title":"J. Bone Jt. Surg. Br."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"281","DOI":"10.3171\/2010.10.SPINE09162","article-title":"Cyclic Sciatica from Extrapelvic Endometriosis Affecting the Sciatic Nerve: Case Report","volume":"14","author":"Floyd","year":"2011","journal-title":"J. Neurosurg. Spine"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1016\/j.jmig.2022.05.017","article-title":"Comparison of Isolated Sciatic Nerve and Sacral Nerve Root Endometriosis: A Review of the Literature","volume":"29","author":"Kale","year":"2022","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1038\/nrendo.2013.255","article-title":"Endometriosis: Pathogenesis and Treatment","volume":"10","author":"Vercellini","year":"2014","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1111\/jog.12998","article-title":"Sciatic Neuroendometriosis: Magnetic Resonance Imaging Defined Perineural Spread of Endometriosis","volume":"42","author":"Cimsit","year":"2016","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1002\/mus.25152","article-title":"Ultrasonography of Sciatic Nerve Endometriosis: Sciatic Nerve Endometriosis","volume":"54","author":"Vermes","year":"2016","journal-title":"Muscle Nerve"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"81","DOI":"10.4103\/GMIT.GMIT_24_18","article-title":"Endometriosis Involving the Sciatic Nerve: A Case Report of Isolated Endometriosis of the Sciatic Nerve and Review of the Literature","volume":"7","author":"Saar","year":"2018","journal-title":"Gynecol. Minim. Invasive Ther."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.wneu.2016.09.111","article-title":"Cyclic Sciatica and Back Pain Responds to Treatment of Underlying Endometriosis: Case Illustration","volume":"97","author":"Uppal","year":"2017","journal-title":"World Neurosurg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/j.fertnstert.2015.08.031","article-title":"Treatment of Pain Associated with Deep Endometriosis: Alternatives and Evidence","volume":"104","author":"Ferrero","year":"2015","journal-title":"Fertil. Steril."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1097\/BSD.0b013e31820fc53b","article-title":"Cyclic Sciatica in a Patient With Deep Monolateral Endometriosis Infiltrating the Right Sciatic Nerve","volume":"24","author":"Ceccaroni","year":"2011","journal-title":"J. Spinal Disord. Tech."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1016\/j.jmig.2017.02.027","article-title":"Five-Year Follow-Up After Laparoscopic Large Nerve Resection for Deep Infiltrating Sciatic Nerve Endometriosis","volume":"24","author":"Possover","year":"2017","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1016\/j.jmig.2020.10.018","article-title":"Postoperative Outcomes after Surgery for Deep Endometriosis of the Sacral Plexus and Sciatic Nerve: A 52-Patient Consecutive Series","volume":"28","author":"Roman","year":"2021","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1517\/14656566.2013.767334","article-title":"An Update on the Pharmacological Management of Endometriosis","volume":"14","author":"Streuli","year":"2013","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"349","DOI":"10.3390\/endocrines3020028","article-title":"Estro-Progestins and Pain Relief in Endometriosis","volume":"3","author":"Luisi","year":"2022","journal-title":"Endocrines"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1097\/AOG.0000000000000964","article-title":"Hormonal Add-Back Therapy for Females Treated With Gonadotropin-Releasing Hormone Agonist for Endometriosis: A Randomized Controlled Trial","volume":"126","author":"DiVasta","year":"2015","journal-title":"Obstet. Gynecol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/j.fertnstert.2017.01.003","article-title":"Progestin-Only Pills May Be a Better First-Line Treatment for Endometriosis than Combined Estrogen-Progestin Contraceptive Pills","volume":"107","author":"Casper","year":"2017","journal-title":"Fertil. 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