Yeungnam Univ J Med.  2021 Apr;38(2):148-151. 10.12701/yujm.2020.00437.

Pudendal nerve entrapment syndrome caused by ganglion cysts along the pudendal nerve

• Kim YJ
• Kim DH

• KMID: 2515189
• DOI: http://doi.org/10.12701/yujm.2020.00437

Abstract

Pudendal nerve entrapment (PNE) syndrome refers to the condition in which the pudendal nerve is entrapped or compressed. Reported cases of PNE associated with ganglion cysts are rare. Deep gluteal syndrome (DGS) is defined as compression of the sciatic or pudendal nerve due to a non-discogenic pelvic lesion. We report a case of PNE caused by compression from ganglion cysts and treated with steroid injection; we discuss this case in the context of DGS. A 77-year-old woman presented with a 3-month history of tingling and burning sensations in the left buttock and perineal area. Ultrasonography showed ganglion cystic lesions at the subgluteal space. Magnetic resonance imaging revealed cystic lesions along the pudendal nerve from below the piriformis to the Alcock’s canal and a full-thickness tear of the proximal hamstring tendon. Aspiration of the cysts did not yield any material. We then injected steroid into the cysts, which resolved her symptoms. Steroid injection into a ganglion cyst should be considered as a treatment option for PNE caused by ganglion cysts.

Keyword

Ganglion cysts; Nerve entrapment; Pudendal nerve; Steroid injection

Figure

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  Fig. 1. Ultrasonographic findings. (A) A 2.6x1.2 cm-sized ganglion cystic lesion (asterisk) at the subgluteal space. (B) Full-thickness tear (arrow) of the proximal hamstring tendon at the ischial tuberosity (IT).

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  Fig. 2. Coronal fat-suppressed T2-weighted images of ganglion cyst courses along the pudendal nerve. (A) A 2.0x0.8 cm-sized ganglion cyst (arrow) below piriformis (P). (B) A 1.8x1.4 cm-sized ganglion cyst (arrow) at the entrance of the Alcock’s canal. (C) A 1.0x0.75 cm-sized ganglion cyst (arrow) within the Alcock’s canal and full-thickness tear (arrowhead) of the proximal hamstring tendon at the ischial tuberosity (IT).

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  Fig. 3. Axial fat-suppressed T2-weighted images of ganglion cyst courses along the pudendal nerve. (A) A 1.0x0.8 cm-sized and 1.2x1.3 cm-sized ganglion cysts (arrows) around the Alcock’s canal. (B) A 1.3x1.5 cm-sized ganglion cyst (arrow) medial to the obturator internus (OI) muscle. (C) A full-thickness tear (arrowhead) of the proximal hamstring tendon at the ischial tuberosity (IT).

Reference

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