A case of scar endometriosis in cesarean scar: A rare case report
Open accessAbstract
Introduction: Scar endometriosis is a rare entity characterized by presence of functional endometrial tissue in the site of surgical scar. Cesarean section scar is the most common reported site. We herein report a case of cesarean scar endometriosis in a 43-years-old female patient. Case presentation. A 43 year old female, with history of lower segment cesarean section 8 years back, presented to our center with complains of pain and palpable lump during menstruation, at the site of cesarean scar. On ultrasonography she was said to have some pathology in her previous surgical scar site. On MRI, a soft tissue mass measuring 25 × 35 mm within the subcutaneous tissue of anterior abdominal wall on the left side was seen. She was planned for surgical removal of the tissue. Discussion: Scar endometriosis is a rare entity. The iatrogenic implantation of the hormone sensitive endometrial tissue into the edge of the wound during surgery best explains its occurrence. They usually present as a painful nodule in the site of surgical scar that undergoes cyclic variation with the menstrual cycle. Diagnosis can be confirmed by radiography. Treatment options can be medical and surgical, the latter being more effective and the preferred one. Conclusion: Scar endometriosis often mimics with variety of clinical conditions, so high degree of suspicion is necessary. Efforts should be aimed at minimizing the transfer of endometrial tissue into the subcutaneous area. Gloves replacement prior to closure can avoid the implantation of endometrial tissue into the abdominal wall. Highlights:
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The most accepted theory for the development of scar endometriosis is the transport theory: iatrogenic implantation of hormone-sensitive endometrial tissue to the edge of a wound during abdominal or pelvic surgery followed by hormone-mediated changes in that implanted tissue causes endometriosis.
“The most accepted theory is the transport theory which explains that the iatrogenic implantation of hormone-sensitive endometrial tissue to the edge of a wound during abdominal or pelvic surgery followed by hormone-mediated changes in that implanted tissue causes endometriosis [8].”
From Abdominal Wall Endometriosis at the Cesarean Section Scar (2023) · cites this paper as [8]
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Cites
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“which explains that iatrogenic implantation of hormone sensitive endometrial tissue to the edge of wound during the abdominal or pelvic surgery followed by hormone mediated changes in those implanted tissue causes endometriosis [1,2,7].”
BackgroundInfluentialCutaneous endometriosis: a combination of medical and surgical treatment
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Research works printed but not linked: 2
- [9]Goel P. Sood S.S. Dalal A. Romilla Cesarean scar endometriosis–report of two cases - PubMed [Internet] Available from: https://pubmed.ncbi.nlm.nih.gov/16340149/ 2022 16340149
- [18]Moazeni-Bistgani Mohammad Recommending Different Treatments as Preventive Measures against Incisional Endometrioma - PubMed Available from: https://pubmed.ncbi.nlm.nih.gov/24971111/ 2022 PMC4064782 24971111
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Abdominal Wall Endometriosis at the Cesarean Section Scar
Rexhepi, M., Asani, L. V., Mulaki, L., Koprivnjak, K., & Azemi, M. (2023) · PRILOZI · doi:10.2478/prilozi-2023-0055 · Cited by 1 · see citing works
- Authors
- Poudel, D., Acharya, K., Dahal, S., & Adhikari, A.
- Affiliations
- Tribhuvan University (NP)
- Chitwan Medical College (NP)
- Tribhuvan University Teaching Hospital (NP)
- Corresponding author
- Acharya, Kshitiz
- Venue
- International Journal of Surgery Case Reports
- Published
- 2023-01
- Volume
- 102
- Issue
- C
- Pages
- 107852-107852
- ISSN
- 2210-2612 (ISSN-L)
- PMC
- PMC9827051
- OpenAlex
- W4312213482
- Cited by
- 14
- References
- 17
- Citations by year
- 2026: 6 · 2025: 1 · 2024: 5 · 2023: 2
- FWCI
- 1.69
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Surgery Case Reports (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Keywords
- scar endometriosis, cesarean section scar, postoperative scarring, abdominal wall mass, dysmenorrhea, surgical gloves, surgical technique modification
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