Scar Endometriosis: A Case Report of This Uncommon Entity and Review of the Literature

Uzunçakmak, Cihangir; Güldaş, Ahmet; Özçam, Hasene; Dinç, Kemal

doi:10.1155/2013/386783

Cited by 18 publications

(37 citation statements)

References 20 publications

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“…Endometriosis is a clinical condition characterized by the presence of ectopic endometrial tissue outside the uterine cavity . It affects women of reproductive age, with a reported prevalence of 10–15% . The ectopic endometrial tissue is usually present in the pelvis, affecting the ovary, posterior cul de sac , pelvic peritoneum and uterine ligaments.…”

Section: Discussionmentioning

confidence: 99%

“…Primary cutaneous endometriosis is a rare type of endometriosis, which arises spontaneously and usually affects the umbilicus. The time to presentation of scar endometriosis following surgery is quite varied, ranging from weeks to months . Scar endometriosis commonly presents as a tender nodular lesion involving scar tissue, with minimal serosanguinous discharge during menstruation.…”

Section: Discussionmentioning

confidence: 99%

“…Scar endometriosis commonly presents as a tender nodular lesion involving scar tissue, with minimal serosanguinous discharge during menstruation. Frequently, this condition is confused with granuloma pyogenicum, suture granuloma, incisional hernia, desmoid tumour, abscess, cyst or lipoma …”

Section: Discussionmentioning

confidence: 99%

“…The mechanism implicated in the pathogenesis of scar endometriosis includes failure to close the parietal and visceral peritoneum with sutures during caesarean section, and implantation of endometrial tissue in the incision site (the coelomic metaplasia theory) …”

Section: Discussionmentioning

confidence: 99%

“…Although the clinical presentation of scar endometriosis is usually characteristic, cytological and histopathological examination confirms the diagnosis. FNAC of lesions offers an advantage over histopathological examination, being a relatively safe, inexpensive and rapid method for confirmation of diagnosis . FNAC demonstrates presence of three cellular components: honeycomb sheets of glandular epithelial cells, fragments of ovoid to spindle‐shaped stromal cells, and presence of background inflammatory cells, including haemosiderin‐laden macrophages, histiocytes and neutrophils .…”

Section: Discussionmentioning

confidence: 99%

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Scar with recurrent serosanguinous discharge

et al. 2014

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A 35-year-old woman presented with a 6-month history of recurrent episodes of bleeding from an abdominal scar. She had a history of lower cervical cesarean section around 2 years previously. Physical examination revealed a linear, vertically oriented scar in the mid line of the anterior abdominal wall. The lower portion of the scar had a hyperpigmented nodular lesion measuring 40 9 20 mm, which expressed scanty serosanguinous discharge on manipulation (Fig. 1a). The rest of the mucocutaneous and systemic examination did not reveal any abnormalities. Histopathological findingsFine needle aspiration cytology (FNAC) was performed on the scar tissue, and this showed glandular epithelial cells, stromal cells and occasional haemosiderin-laden macrophages against a haemorrhagic background (Fig. 1b). Figure 1 (a) Vertical abdominal scar with nodular lesion associated with serosanguinous discharge; (b) endometrial and stromal cells (May-Grunwald-Giemsa, original magnification 9 400.ª

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Scar with recurrent serosanguinous discharge

et al. 2014

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Clinico-pathological assessment of surgically removed abdominal wall endometriomas following cesarean section

Hasan

Deyab

Monazea

et al. 2021

Annals of Medicine and Surgery

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Background Over the past few decades, the rate of Cesarean Section (CS) delivery has been rising rapidly and the prevalence of CS-associated complications including Abdominal Wall Endometriomas (AWE) increases with each additional operation. The aim of this study was to evaluate the clinical characteristics, histopathological diagnostic role and surgical management of post-CS AWE through a retrospective case review. Methods We calculated the incidence of AWE and reviewed all the patients underwent surgical removal of Post-CS AWE during the period of 2012–2018 who were diagnosed, treated and followed up for 2–8 years at our tertiary hospital. Results Thirty women with AWE were included. The main symptom in 2/3 of cases was cyclic pain and 4 cases (13.3%) had no symptoms. The mean interval between prior CS and appearance of symptoms was 55.2 months and the mean size of the excised mass was 42 mm. Free surgical margin was less than 9 mm in 9 patients (30%) but no recurrence was recorded among all the studied patients. Pre-operative FNAC diagnosis was performed for only 3 patients (10%) which helped in excluding other potential pathologies. The clinical–pathological agreement value for detection of the nature of the abdominal wall mass was 93.4%. Conclusions Patients with suspected AWE should undergo preoperative cytological biopsy to exclude alternative diagnosis. Wide surgical excision with margin of less than 1 cm could be accepted especially in case of weak abdominal wall. More studies on the post-CS complications; risks, prevention, early detection and proper management should be encouraged.

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Sonographic Findings of Abdominal Wall Endometriosis in Persistent Abdominal Wall Pain: A Case Report

Machač,

Hanušová,

Hroncová

et al. 2023

Journal of Women's &Amp; Pelvic Health Physical Therapy

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Introduction/Background: Endometriosis is considered a chronic neuroinflammatory disease of debilitating pain, most often in the pelvic area. In rare cases, endometriosis can develop through iatrogenic implantation of endometrial cells/fragments into a scar area during the cesarean delivery. Case Description: A case of a 32-year-old female patient who underwent physical therapy for abdominal muscle pain with occasional irradiation of pain to the sacral region is presented. The pain developed soon after a cesarean delivery, which was performed 3 years ago. Outcomes: Palpation performed at the initial examination and after removal of the lesions showed a significant reduction in tone at the site of the lesions and a reduction in palpation pain. The objective primary tools and specific outcome measures used in this case were musculoskeletal sonography and a patient questionnaire (36-Item Short Form Health Survey [SF-36]). Abdominal wall lesions were found to be 34 × 13 × 40 mm and 30 × 15 × 22 mm in size and were surgically removed by a specialized surgeon with histological confirmation of endometriosis. The SF-36 scores considerably improved in all domains following removal of the lesions compared with the condition at the initial examination. Discussion: The presented case is an example of the musculoskeletal sonography evaluation following palpation of the abdominal wall in women after a cesarean delivery. The described sonographic examination performed by a physical therapist can be part of a comprehensive assessment of scar healing, diastasis, and the ability to activate the abdominal muscles during postpartum rehabilitation. Informed Consent: The patient signed informed consent, in which she agreed to the anonymous publication of her case. A supplemental video abstract available at: https://www.youtube.com/watch?v=Vd87WB8ZQd0&t=16s

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Scar Endometriosis: A Case Report of This Uncommon Entity and Review of the Literature

Cited by 18 publications

References 20 publications

Scar with recurrent serosanguinous discharge

Scar with recurrent serosanguinous discharge

Clinico-pathological assessment of surgically removed abdominal wall endometriomas following cesarean section

Sonographic Findings of Abdominal Wall Endometriosis in Persistent Abdominal Wall Pain: A Case Report

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