Pfannenstiel Scar Recurrences in Endometrial Cancers: A Case Series and Review of Literature

Abstract

Endometrial cancer recurrences are usually either pelvic or distant metastases. Isolated scar recurrence is a rare entity, with approximately 43 cases being reported in the literature. The study highlights that most scar recurrences can be offered curative treatment with radical surgery. In our series, all the recurrences were in a previous Pfannenstiel incision scar. We report a series of four cases of isolated Pfannenstiel scar recurrences in patients with endometrial cancer who had undergone total abdominal hysterectomy and salpingo-oophorectomy. All four patients underwent curative radical surgery. Two patients had associated inguinal lymph node involvement, for which ilio-inguinal block dissection was done for one patient and en bloc resection of the node along with the recurrent disease was done for the other patient. We reviewed the previous literature to ascertain the possible aetiology of incisional recurrence, especially the isolated scar recurrences. In patients presumed to be having carcinoma endometrium, proper incision and surgical technique with good exposure, during the initial surgery, is important so as to minimise scar recurrence. Most of the isolated scar recurrences can be surgically resected with a curative intent.