Real Talk on Endometriosis

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Literature case report: Endometriosis of the wrist

Endometriosis is not confined to reproductive organs; it has been documented in multiple anatomical regions throughout the body. Reports describe involvement of gastrointestinal, urinary, thoracic, and musculoskeletal structures, underscoring its capacity to affect diverse sites and present with atypical symptoms.

A 23‑year‑old woman presented with intermittent pain and swelling of the right wrist, persisting for nearly three years after a mild injury. Initial management for presumed wrist sprain with nonsteroidal anti‑inflammatory drugs and local steroid injections was unsuccessful. Over time, her symptoms were noted to be cyclical and associated with menstruation.

Magnetic resonance imaging revealed a multiloculated mass measuring 2 × 1.5 × 1.5 cm on the volar side of the ulnar head, with mixed signal intensity and areas of hyperintensity consistent with hemorrhage. The differential diagnosis included tenosynovial giant cell tumor and endometriosis.

Exploratory surgery demonstrated an unencapsulated mass infiltrating the distal radioulnar joint. Histopathological evaluation confirmed endometriosis, with endometrial glands embedded within connective tissue of the wrist. Immunohistochemical staining for CD10, estrogen receptor, and progesterone receptor was positive, supporting the diagnosis.

Ding Y, Gibbs J, Xiong G, Guo S, Raj S, Bui MM. Endometriosis Mimicking Soft-Tissue Neoplasms: A Potential Diagnostic Pitfall. Cancer Control. 2017 Jan;24(1):83-88. doi: 10.1177/107327481702400114. PMID: 28178719.

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