Intermuscular lipoma of the gluteus muscles compressing the sciatic nerve: an inverted sciatic hernia

Case report

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The authors report the case of a 50-year-old woman with a benign intermuscular lipoma of the gluteus compressing the sciatic nerve in its course through the sciatic notch. This benign soft-tissue tumor extended into the pelvis, displacing the rectum laterally. Resection was necessary to alleviate symptoms and prevent irreversible damage of the nerve. Wide exposure of the piriformis muscle and sciatic nerve via a transgluteal approach allowed safe lesion removal, and thus avoiding a laparotomy to resect the intrapelvic extension of the tumor. This report features a curious case of soft-tissue tumor growth across the sciatic foramen forming an inverted sciatic hernia. The authors' proposed approach was simple and safe and avoided a laparotomy.

Article Information

Contributor Notes

Address correspondence to: Eudaldo López-Tomassetti Fernández, M.D., Department of Surgery, Avenida Marítima del Sur, s/n, Las Palmas, Las Palmas de Gran Canaria 35016, Spain. email: include this information when citing this paper: published online August 17, 2012; DOI: 10.3171/2012.7.JNS111714.

© AANS, except where prohibited by US copyright law.

  • 1

    Botwin KPShah CPZak PJ: Sciatic neuropathy secondary to infiltrating intermuscular lipoma of the thigh. Am J Phys Med Rehabil 80:7547582001

    • Search Google Scholar
    • Export Citation
  • 2

    Flores LPCarneiro JZ: Peripheral nerve compression secondary to adjacent lipomas. Surg Neurol 67:2582632007

  • 3

    Hunt JAThompson JF: Giant infiltrating lipoma of the thigh causing sciatica. Aust N Z J Surg 67:2252261997

  • 4

    Kerry RLTygart RLGlas WW: Lipoma: a “reversed” perineal sciatic hernia. Am J Surg 107:8838841964

  • 5

    Kim DHMurovic JATiel RLMoes GKline DG: A series of 146 peripheral non-neural sheath nerve tumors: 30-year experience at Louisiana State University Health Sciences Center. J Neurosurg 102:2562662005

    • Search Google Scholar
    • Export Citation
  • 6

    Losanoff JEBasson MDGruber SAWeaver DW: Sciatic hernia: a comprehensive review of the world literature (1900–2008). Am J Surg 199:52592010

    • Search Google Scholar
    • Export Citation
  • 7

    Martel L: Pointede hernie ischiatique: impotence fonctionelle du membre inferieur pendant 5 mois operation Guerison. Loire Med 19:1651741900

    • Search Google Scholar
    • Export Citation
  • 8

    Murphey MDCarroll JFFlemming DJPope TLGannon FHKransdorf MJ: From the archives of the AFIP: benign musculoskeletal lipomatous lesions. Radiographics 24:143314662004

    • Search Google Scholar
    • Export Citation
  • 9

    Nishida JMorita TOgose AOkada KKakizaki HTajino T: Imaging characteristics of deep-seated lipomatous tumors: intramuscular lipoma, intermuscular lipoma, and lipoma-like liposarcoma. J Orthop Sci 12:5335412007

    • Search Google Scholar
    • Export Citation
  • 10

    Skipworth RJSmith GHStewart KJAnderson DN: The tip of the iceberg: a giant pelvic atypical lipoma presenting as a sciatic hernia. World J Surg Oncol 4:332006

    • Search Google Scholar
    • Export Citation
  • 11

    Spring DBVandeman FWatson RA: Computed tomographic demonstration of ureterosciatic hernia. AJR Am J Roentgenol 141:5795801983



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