Abdominal scar endometriosis

Cavalcante²,

Diagnostic Cytopathology

et al. 2010

Endometriosis is defined as the presence of endometrial-like glands and stroma outside the uterine endometrial lining. Endometrial tissue has also been identified in numerous surgical or procedure scars, including cesarean section and laparoscopic trocar tract. A prospective study was conducted at Maternidade-Escola Assis Chateaubriand, Faculty of Medicine, Federal University of Ceara, Brazil in seven patients with abdominal wall mass pathologically proven as scar endometriosis from January 2004 to December 2008. All cases were submitted to fine-needle aspiration cytology (FNAC). Age ranged from 21 to 42 years old (mean: 30) with parity ranging from 0 to 3 (mean: 1.4). The preceding history of pelvic procedures was miomectomy (1 of 7), cesarean section (3 of 7), and diagnostic laparoscopy (3 of 7). The complaints occurred about 18 months after the surgical proceeding. The FNAC findings were endometrial-like epithelial cells (6 of 7) and stromal cells (6 of 7); decidualization occurred in 2 of 7 cases. Hemosiderin-laden macrophages were present in all cases. FNAC is a fast and accurate method to make the diagnosis before the surgery, avoiding errors in the approach of the abdominal wall endometriosis' scars.

Section: Discussionsupporting

confidence: 70%

“…It is important to make the differential diagnosis with abdominal wall tumors (lipoma, sarcoma, and metastasis), hematoma, abscess, keloid, and hypertrophic scar 15. Imaging techniques are nonspecific and needle biopsy may confirm the diagnosis 2, 13, 22–25.…”

Section: Discussionmentioning

confidence: 99%

Fine‐needle aspiration cytology of scar endometriosis: Study of seven cases and literature review

Cavalcante²,

Diagnostic Cytopathology

et al. 2010

“…Endometriosis should be considered in differential diagnosis of a painful mass in anterior abdominal wall, especially in women with a history of pelvic or obstetric surgery. According to our findings and the literature (2,4,(6)(7)(8)(9)(10)(11)(12)(13)(14)24,25), previous cesarean section is the most well known risk factor in etiology. This suggests that the disease is highly caused by iatrogenic sowing.…”

Section: Resultssupporting

confidence: 67%

“…None of these theories can exactly explain the whole case. Therefore, some researchers claim that genetic and environmental factors together play a role in the etiology of endometriosis (11). Cesarean section is one of the most common causes of AWE (2,6).…”

Section: Discussionmentioning

confidence: 99%

“…For both treatment and reducing the risk of lesion recurrence, the mass should be widely excised with at least 1 cm margin (6,21). After surgical excision, defect can be repaired by using autologous or synthetic graft according to the width of the defect and its anatomical localization (11,22). Postoperative adjuvant hormone therapy such as danazol, progesterone and GnRH analogs are recommended for patients with concomitant pelvic endometriosis or recurrent AWE (21,23).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Abdominal Wall Endometriosis: Analysis of 66 Patients at a Tertiary Center

Bacanakgıl¹,

Özçam²,

Deveci̇³

et al. 2019

Istanbul Med J

Introduction: The objective of this study was to review the patients' characteristics and surgical findings of surgically excised abdominal wall endometriosis (AWE) cases. Methods: We retrospectively analyzed the medical records of patients diagnosed with AWE between 2005 and 2015. Descriptive data were collected and analyzed. Results: Sixty-six patients with histopathological diagnosis of AWE were included in our study. The mean age was 32±6.8 years and all cases were multiparous. All patients had a history of previous abdominal surgery and 63 patients had a history of cesarean delivery. The primary symptom was a painful palpable mass. The excised mass was generally on the previous surgical scar. The excised mass location was observed as subcutaneous tissue, fat layer, fascia and muscle tissue. There was no statistical correlation depth of invasion and mass size with the number of previous surgeries. Conclusion: Caesarean incision was considered as the most important predisposing factor for AWE. As caesarean rates are increasing, we believe that the incidence of AWE will increase in the future. For this reason, more prospective studies are needed for prognosis and prophylaxis of the disease.

Surgical Treatment of Scar Endometriosis Following Cesarean Section, a Series of 12 Cases

2013

It is difficult to conduct studies with larger series in rarely observed diseases. We report our experience in managing cesarean scar endometriosis (CSE) and emphasize the diagnosis and treatment options. The objective of our study is to review the clinical characteristics of CSE and to evaluate our surgical outcomes. We have collected and documented a case series of 12 patients who underwent surgical wide en bloc excision with surrounding clear margins for CSE. Patients' demographic features, symptoms, and clinical and operative findings were evaluated. The mean age was 34.6 years. Cyclical pain was documented in seven patients, while three patients presented with noncyclical pain. Menstrually-related enlargement of the nodule was observed in four patients, and only one patient had a complaint of dark brown leakage. The mean operation time was 26 min. The endometriotic lesions ranged from a diameter of 2 to 8 cm in size. Patients recovered completely, and no recurrence was observed. To prevent iatrogenic transplantation, additional attention is needed during surgery that exposes endometrial tissue. Complete wide excision of CSE is both diagnostic and therapeutic. To avoid unnecessary referrals, awareness of its typical clinical manifestations remains the mainstay for intervention. The most important issues to be considered during surgery is nonspreading endometriosis while manipulation.