Abdominal wall endometriosis: a case report

Abstract

Abdominal wall endometriosis is the development of endometrial tissue in the anterior abdomen usually due to an operation in which the uterus is manipulated. We herein delineate the presentation, clinical investigation, and surgical treatment of an abdominal wall endometriosis case. A 42-year-old female presented with acute abdominal pain in the lower quadrants in the margins of an old cesarean scar. Two masses in the abdominal wall highly suspected of consisting of endometrial tissue were found during the investigation of the patient. These ones were removed in surgery and endometrial tissue secondary to previous cesarean section was confirmed after histological analysis. Consequently, although rare, if a painful mass in a surgical scar, such as a Pfannenstiel incision, is found in women of reproductive age with a history of obstetric surgery, the differential diagnosis shall include endometriosis. There is a portion of cases in which endometriosis recurs within five years following conservative surgery.

Abdominal wall endometrioma after Cesarean section: a case series

“…AWE may also be an incidental finding following Cesarean section with onset of symptoms ranging from months to 17.5 years with an average of 55.2 months [ 6 ]. This long range of time prior to determination of AWE as the diagnosis has been attributed to designating this pathology as other masses like desmoid tumors, suture granulomas, abscesses, hematomas, sarcomas, lipomas, metastatic lesions, or hernias [ 6 , 7 ]. While excision is usually performed for symptomatic relief, it also decreases the risk of malignant transformation as AWE confers a risk of malignancy in 0.3–1% of cases with clear cell carcinoma being the most common form [ 8 ].…”

Abdominal Wall Endometriosis at the Cesarean Section Scar

“…The most common site of extra pelvic endometriosis is the abdominal wall (4%) and is associated with prior surgical scars following gynecologic abdominal procedures like cesarean section, myomectomy, hysterotomy, hysterectomy, or tubal ligation [4]. Cesarean scar endometriosis is the most common abdominal wall endometriosis, with an estimated incidence of 0.03-0.4% [5].…”