Incisional Endometriosis: Diagnosed by Fine Needle Aspiration Cytology

Abstract

Incisional endometriosis (IE) is a rare entity reported in 0.03–1.08% of women following obstetric or gynecologic surgeries. Most cases reported in literature have appeared after cesarean sections and were often clinically mistaken for hernia, abscess, suture granuloma or lipoma. We hereby report a case of IE following a second trimester hysterotomy, which was diagnosed by fine needle aspiration cytology (FNAC). Our patient was 26 years old, presenting with a mass over anterior abdominal wall, associated with incapacitating pain during each menstrual cycle. FNAC showed epithelial cells, stromal cells and hemosiderin laden macrophages. Based on the typical history, clinical and cytological features, the diagnosis of IE was established. Wide surgical excision was done and the resulting rectus sheath defect was repaired. Patient was followed for 6 months during which time she was symptom free. This article also reviews the spectrum of cytological features and the rare possibility of malignant transformation that can occur in IE.

Fine needle aspiration cytology diagnosis of caesarean scar endometriosis with histopathological correlation: a case report

“…Endometriosis occurring in a surgical scar is called incisional endometriosis or scar endometriosis. 3 The first case of scar endometriosis was reported by Meyer in 1903. 4 Blanco et al reported 12 cases of scar endometriosis.…”

“…The presence of any two of the three components is required for the diagnosis of endometriosis. 3 Medical management with oral contraceptive pill, progestogens and gonadotropin releasing hormone analogues provide alleviation of symptoms, but recurrence after cessation of therapy is common. Wide surgical excision with at least 1 cm margin on all sides is the treatment of choice.…”

A Rare Case of Spontaneous External Endometriosis Arising From Rectus Abdominis Muscle

“…FNAC can confirm the diagnosis by demonstrating epithelial cell, stromal cells and hemosiderin-laden macrophages. [3] MRI is gold standard, which can detect small lesions and confirm its vascularity.…”

Incisional endometriosis: A rare cause for a painful scar - A report and commentary

“…The true incidence of endometriosis is not known, but it is believed that 10-15% of all women in their reproductive age develop endometriosis and 25-35% of all women who are infertile have endometriosis 1. Incisional endometriosis (IE) is a rare entity reported in 0.03-1.08%2 of women following obstetric or gynaecological surgeries. Most cases reported in the literature have appeared after caesarean sections and were often clinically mistaken for hernia, abscess, suture granuloma, or lipoma 2.…”

“…Incisional endometriosis (IE) is a rare entity reported in 0.03-1.08%2 of women following obstetric or gynaecological surgeries. Most cases reported in the literature have appeared after caesarean sections and were often clinically mistaken for hernia, abscess, suture granuloma, or lipoma 2. The diagnosis is frequently made only after excision of the diseased tissue.…”