Intrauterine endometrial cyst after low uterine incision

Abstract

Rationale:During the surgical procedure, endometrial cells can be seeded into the wound edge of the uterine wall, developing into scar endometriosis. Due to the extremely low incidence, estimation of its prevalence is still unavailable. Even rarer might be the scar endometriosis in uterine cavity, to our best knowledge, a situation has not been reported yet.Patient concerns:A 37-year-old woman complained of heavier and prolonged menstruation as well as pelvic pain during menses for more than 4 months. An endometrial cyst in diameter of 6 cm in uterine cavity was revealed by transvaginal ultrasound. Her surgical history was significant for 1 caesarean section and 1 abdominal myomectomy through transverse incision of lower uterine segment.Diagnoses:Space-occupying lesions in uterine cavity, moderate anemia and scar uterus.Interventions:The hysteroscopy was performed and a multilocular cyst full of chocolate-like fluid was removed. Pathological examination confirmed endometrial glands in the removed cyst tissue.Outcomes:During the follow-up visits at 1 and 6 months after surgery, the patient denied any special discomfort. Her postoperative transvaginal ultrasound showed an enlarged uterus with no lesion in uterine cavity. To achieve a better surveillance, a 3-year period of follow-up after surgery at a 6-month interval was suggested.Lessons:Intrauterine endometriosis should be considered in patients of pelvic surgery history with pelvic pain, menstrual disorder, and intrauterine cystic mass.

Ultrasound-Guided Transvaginal Aspiration and Sclerotherapy for Uterine Cystic Adenomyosis: Case Report and Literature Review

“…The resultant damage in the junction between endometrium and myometrium can cause secondary adenomyosis, which occasionally evolves into uterine cystic adenomyosis ( 39 ). Previous reports have identified eight cases of uterine cystic adenomyosis developing in the presence of the above-mentioned high-risk factors ( 11 , 29 , 37 , 38 , 40 , 43 ). However, the present case had not previously undergone any surgery.…”

Recurrent mucinous neoplasm arising in cesarean scar: A case report and review of literature

“…The pathophysiology of scar endometriosis may be due to direct implantation of endometrial tissues into the scar tissues during operations performed during pregnancy. 8,[18][19][20][21] Although very rare, gestational trophoblastic neoplasia (GTN), such as molar pregnancy, choriocarcinoma, and atypical placental site nodule, can also arise in the cesarean section scar. 2,3,6 The incidence rate of GTN localized in the cesarean scar was 3.3% in all patients diagnosed with GTN.…”

“…Compared with abdominal scar endometriosis, uterine scar endometriosis is less common, with few cases reported in the literature. The pathophysiology of scar endometriosis may be due to direct implantation of endometrial tissues into the scar tissues during operations performed during pregnancy 8,18–21 …”

“…Cesarean section delivery rates have increased in recent years and this brings some complications related to the procedure. Some lesions, such as isthmocele, cesarean section scar pregnancy, endometriosis, molar pregnancies, and gestational trophoblastic diseases, may arise in the scar tissue formed in the uterus after a cesarean section 2–9 . With the increase in cesarean section procedures in daily practice, we must become familiar with the lesions developing in cesarean section scars.…”

“…Some lesions, such as isthmocele, cesarean section scar pregnancy, endometriosis, molar pregnancies, and gestational trophoblastic diseases, may arise in the scar tissue formed in the uterus after a cesarean section. [2][3][4][5][6][7][8][9] With the increase in cesarean section procedures in daily practice, we must become familiar with the lesions developing in cesarean section scars. Herein, we present what we believe to be the first case of a recurrent mucinous neoplasm with features of borderline neoplasia arising within a cesarean scar.…”