Endometrioma de parede abdominal

Abstract

headings -Endometriosis. Abdominal wall.abstRact -Background: The exact incidence of endometriosis in the general population is unknown. Confirmation of this disease is only possible by histopathological analysis of a fragment obtained by some invasive procedure, because there is so far, no clinical secure marker. Aim: To report the experience with the clinical manifestations and surgical treatment in patients with abdominal wall endometrioma. Methods: Retrospective analysis of patients operated for abdominal wall endometrioma with emphasis on data relating to age, symptoms, previous cesarean, relation of symptoms with the menstrual cycle, physical examinations and additional surgical treatment, postoperative course and histopathological results of specimens. Results: Forteen patients were operated during the study period, aged between 28 and 40 years. The presence of local mass and pain that worsened during menstruation were the main complaints. Ultrasound and CT examinations were important to precisely localize the disease. Surgical excision was a wide excision of the tumor and affected tissues. The patient progressed satisfactorily and histopathology confirmed the diagnosis of abdominal wall endometrioma in all cases. Conclusion: Exists a clear relationship between cesarean operation and abdominal wall endometrioma; ultrasound studies and CT scans help to plan the surgical resection allowing resection of tumor and all affected adjacent tissues. Resumo -Racional:A incidência exata da endometriose na população geral é desconhecida. A confirmação desta doença só é possível através da análise histopatológica de um fragmento obtido por algum procedimento invasivo, pois não existe até o momento, nenhum marcador clínico seguro. Objetivo: Relatar a experiência com as manifestações clínicas e o tratamento cirúrgico em pacientes com endometrioma de parede abdominal. Método: Análise retrospectiva das pacientes operadas por endometrioma de parede abdominal, dando ênfase aos dados relativos à idade, sintomas, cesariana prévia, relação dos sintomas com o ciclo menstrual, exames físicos e complementares, tratamento cirúrgico, evolução pós-operatória e resultado histopatológico dos espécimes. Resultados: Foram operadas 14 pacientes no período estudado, com idade entre 28 e 40 anos. A presença de massa e dor local que piorava durante a menstruação foram as queixas principais. Ultrassonografia e tomografia computadorizada foram exames importantes em localizar precisamente a doença. O tratamento cirúrgico foi exérese ampla da tumoração e dos tecidos comprometidos. As pacientes evoluíram satisfatoriamente e o histopatológico confirmou a suspeita de endometrioma de parede abdominal em todos os casos. Conclusão: Foi nítida a relação entre cesariana prévia e endometrioma de parede abdominal e estudos ultrassonográficos e tomográficos auxiliaram a planejar a abordagem cirúrgica permitindo a exérese da tumoração e de todos os tecidos adjacentes comprometidos.correspondência:

Abdominal Wall Endometrioma Mimicking Pubalgia: A Case Report

“…Among them are intra-articular pathologies of the hip, urological diseases, abdominal wall dysfunctions, and gynecological diseases [6][7][8][9]. We highlighted the abdominal wall endometrioma, with few reports of occurrence in the world literature [8][9][10]. In the previous literature, we did not find a description of an abdominal wall endometrioma mimicking a pubalgia condition, as described in this report.…”

“…The prevalence ranges from 8 to 15% of women of childbearing age 10 and can be either pelvic or extra-pelvic. Endometriosis of the rectus abdominis muscle, as described in this clinical case, is rare, with only about 20 cases found in the literature [8][9][10]. When it forms a circumscribed mass, endometriosis is called an endometrioma [8].…”

“…Treatment is eminently non-surgical, with physiotherapy, withdrawal from sports, systemic or local corticosteroids, and non-hormonal anti-inflammatory drugs. Among the differential diagnoses of pubalgia are intra-articular pathologies of the hip, sacroiliitis, urological diseases, inguinal hernias, and gynecological diseases [6][7][8][9]. In this last group, there are ovarian cysts and abdominal wall endometriosis.…”

“…One of the most common sites for the appearance of endometrioma is in the lower abdominal wall, especially if there is a local scar (by cesarean section or other surgery). The incidence of abdominal wall endometrioma after the cesarean section varies from 0.03 to 0.8% of cases [8,9].…”

“…There is a multitude of differential diagnoses for pubalgia. Among them are intra-articular pathologies of the hip, urological diseases, abdominal wall dysfunctions, and gynecological diseases [6][7][8][9]. We highlighted the abdominal wall endometrioma, with few reports of occurrence in the world literature [8][9][10].…”