Endometriosis causing lower extremity deep vein thrombosis - case report and review of the literature

Abstract

Endometriosis is a medical condition in women wherein endometrial cells deposited in the area outside the uterine cavity are influenced by hormonal changes, and produce symptoms depending on the site of implantation. A unique case of retroperitoneal endometriosis causing deep vein thrombosis from extrinsic compression of the right iliac vein is described. Clinical presentation with cyclical leg swelling, coincidental with menstruation and culminating with deep vein thrombosis, although very suggestive, has not been previously reported.

Figure 1)

Computed tomography of the sacrum. A Thrombosis of the right femoral vein (arrow). B A 3 cm soft tissue mass encircling the right external vein (arrow). C Bone window showing subtle sclerosis of the right sacrum (arrow)

Figure 2)

Transpopliteal venogram showing extensive deep vein thrombosis of the femoral and external iliac vein. The right common iliac vein and inferior vena cava are normal

Figure 3)

Post-thrombolysis venogram showing resolution of the femoral and external iliac vein, and smooth narrowing of the external iliac vein (arrow) (A), as well as successful stenting of the external iliac vein (B)

Figure 4)

Posterior computed tomography-guided biopsy of the retro-peritoneal paraspinal mass around the stented right external iliac vein (arrow)

Figure 5)

Right retroperitoneal paraspinal mass needle biopsy. Benign stromal tissue consisting of small spindle cells that stained positive for CD10 on immunoperoxide staining. Reproduced with permission from Dr Arthur R Gaba, Pathology and Laboratory, Henry Ford Hospital, Detroit, Michigan, USA