Cutaneous endometriosis is a rare disease and has remained a diagnostic enigma. It usually presents as a mass in the vicinity of a previous scar. We present a 34-year-old lady who presented with a mass along an initial caesarean section scar. The mass was progressively increasing in size. She was seen in the surgical outpatient department and had surgical excision for a clinical diagnosis of soft tissue fibroma with a differential of foreign body granuloma. Histology of the resected specimen was diagnostic of cutaneous endometriosis. Scar endometriosis should be considered always in abdominal wall nodules present along a previous scar and adequate cleaning of surgical incisions should be done during uterine surgery to prevent implantation.
Cite this paper
Omenai, S. A. and Egbo, O. H. (2022). Scar Endometriosis: A Diagnostic Conundrum. Open Access Library Journal, 9, e9025. doi: http://dx.doi.org/10.4236/oalib.1109025.
Kaplanoglu, M., Kaplanoglu, D.K., Ata, C.D. and Buyukkurt, S. (2013) Obstetric Scar Endometriosis: Retrospective Study on 19 Cases and Review of the Literature. ISRN Obstet Gynecol, 2014, Article ID: 417042.
https://doi.org/10.1155/2014/417042
Bagade, P.V. and Guirguis, M.M. (2009) Menstruating from the Umbilicus as a Rare Case of Primary Umbilical Endometriosis: A Case Report. Journal of Medical Case Reports, 3, 4-6. https://doi.org/10.1186/1752-1947-3-9326
Akbulut, S., Mahsuni Sevinc, M., Bakir, S., Cakabay, B. and Sezgin, A. (2010) Scar Endometriosis in the Abdominal Wall: A Predictable Condition for Experienced Surgeons. Acta Chirurgica Belgica, 110, 303-307.
https://doi.org/10.1080/00015458.2010.11680621
Low, R.S., Jones, A.O., Houang, M., Newland, L., Morey, A.L. and Chan-Ling, T. (2007) Endometriosis of the Inguinal Region: Magnetic Resonance Imaging (MRI) Findings. Australasian Radiology, 51, 272-275.
https://doi.org/10.1111/j.1440-1673.2007.01804.x
Aydin, Ö. (2007) Scar Endometriosis—A Gynaecologic Pathology often Presented to the General Surgeon Rather than the Gynaecologist: Report of Two Cases. Langenbeck's Archives of Surgery, 392, 105-109.
https://doi.org/10.1007/s00423-006-0107-8
Singh, M., Sivanesan, K., Ghani, R. and Granger, K. (2009) Caesarean Scar Endometriosis. Archives of Gynecology and Obstetrics, 79, 217-219.
https://doi.org/10.1007/s00404-008-0672-x
Ramesh, B., Chaithra, T.M., Gupta, P. and Prasanna, G. (2016) Anterior Abdominal Wall Scar Endometriosis: An Enigma. The Journal of Obstetrics and Gynecology of India, 66, 636-638. https://doi.org/10.1007/s13224-015-0777-7
Miccini, M., Gregori, M., Ferraro, D., Ciardi, A., Cassibba, S. and Biacchi, D. (2016) Abdominal Scar Endometriosis: Case Report. Clinical and Experimental Obstetrics & Gynecology, 43, 431-433. https://doi.org/10.12891/ceog3487.2016
Manerikar, K., Singh, G., Kore, R. and Nongmaithem, M. (2016) Abdominal Wall Endometriosis: Case Report and Review of Literature. Shiraz E-Medical Journal, 3, 995-997. https://doi.org/10.18203/2349-2902.isj20161186
Ozel, L., Sagiroglu, J., Unal, A., Unal, E., Gunes, P., Baskent, E., et al. (2012) Abdominal Wall Endometriosis in the Cesarean Section Surgical Scar: A Potential Diagnostic Pitfall. Journal of Obstetrics and Gynaecology Research, 38, 526-530.
https://doi.org/10.1111/j.1447-0756.2011.01739.x
Pathan, S.K., Kapila, K., Haji, B.E., Mallik, M.K., Al-Ansary, T.A., George, S.S., et al. (2005) Cytomorphological Spectrum in Scar Endometriosis: A Study of Eight Cases. Cytopathology, 16, 94-99. https://doi.org/10.1111/j.1365-2303.2004.00218.x
Sedhain, N., Dangal. G., Karki, A., Pradhan, H.K., Shrestha, R., Bhattachan, K., et al. (2018) Caesarean Scar Endometriosis. Journal of Nepal Health Research Council, 15, 292-294. https://doi.org/10.3126/jnhrc.v15i3.18859
Ding, Y. and Zhu, J. (2013) A Retrospective Review of Abdominal Wall Endometriosis in Shanghai, China. International Journal of Gynecology & Obstetrics, 121, 41-44. https://doi.org/10.1016/j.ijgo.2012.11.011
Park, S.W., Hong, S.M., Wu, H.G. and Ha, S.W. (1999) Clear Cell Carcinoma Arising in a Cesarean Section Scar Endometriosis: A Case Report. Journal of Korean Medical Science, 14, 217-219. https://doi.org/10.3346/jkms.1999.14.2.217
