Abstract
Endometriosis of the abdominal wall scar is rare, reported incidence being 1.08% for mid-trimester abortion and 0.03–0.4% following caesarean sections. Incisional endometriosis is a relatively rare entity and is often misdiagnosed as stitch granuloma, abscess, incisional hernia, lipoma, hematoma, desmoid tumor, sarcoma, lymphoma, or primary and metastatic cancer. We report three cases of abdominal scar endometriosis; two cases occurring in the surgical scar of previous caesarean incision and one case occurring after second trimester hysterotomy. The present study describes the physical signs and symptoms and cytological features of abdominal scar endometriosis. A high index of suspicion is needed for early diagnosis of this entity in a woman presenting with post operative abdominal lump. DOI: 10.21276/APALM.2017.1029
Highlights
Endometriosis is defined as the presence and proliferation of the endometrium outside the uterine cavity
Endometriosis in an abdominal scar is rare, reported incidence being 1.08% for mid-trimester abortion and 0.03–0.4% following caesarean.[3,4]. This entity is often misdiagnosed as stitch granuloma, abscess, incisional hernia, lipoma, hematoma, desmoid tumor, sarcoma, lymphoma, or primary and metastatic cancer.[4]
The present study describes 3 cases of scar endometriosis with the cytological features, physical signs and symptoms that may lead to earlier diagnosis and treatment
Summary
Endometriosis is defined as the presence and proliferation of the endometrium outside the uterine cavity. Case 1: A 30-year-old female (G4P3) presented with a nodule over anterior abdominal wall scar, 8 month after second trimester hysterotomy. It was associated with increase in size and pain during menstrual cycle. Examination revealed a well-defined, 3 × 3 cm tender and hyperpigmented nodule over the anterior abdominal hysterotomy scar (Figure 1). Case 2: A 25 year old female presented with a 2 month history of persistent and continuous pain on anterior abdominal wall and had history of caesarian section 3 years back. Case no 3: A 28 yr old female presented with a nodule associated with ulceration over anterior abdominal wall. Annals of Pathology and Laboratory Medicine, Vol 04, No 01, January - February, 2017
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