Intramedullary Endometriosis of the Conus Medullaris: Case Report

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.