Cited by 18Endometriosis Research and TreatmentGynecological conditions and treatmentsEctopic Pregnancy Diagnosis and Management

Scar endometriosis: A series of 3 cases

Open access
Tangri, M.K., Lele, Prasad, Bal, H., Tewari, Rohit, Majhi, Debkalyan·2016·Medical Journal Armed Forces India

AI snapshot

Written from the paper’s full text.

TL;DR

Scar endometriosis is a rare, often diagnostically challenging entity that can present with cyclical pain or swelling at a previous obstetric/gynecological scar. This case series reports three women with post-cesarean scar endometriosis treated by wide local excision, all confirmed by histopathology and asymptomatic on follow-up.

Key findings

  • Three women aged 40, 36, and 33 years, with 2, 2, and 1 previous cesarean sections respectively, presented 12, 12, and 2 years after their last surgery with cyclical scar symptoms; all had scar endometriosis in a post-cesarean scar.
  • Diagnostic tests were inconsistent: ultrasound localized the lesion in Case 1, was inconclusive in Case 2, and suggested granuloma in Case 3; FNAC in Case 1 was inconclusive; MRI in Case 2 suggested scar endometriosis. Histopathological examination was confirmatory in all three cases.
  • Intraoperative findings included masses described as 4 cm × 3 cm densely adherent to the rectus sheath (Case 1), 5 cm × 5 cm invading subcutaneous tissue, rectus sheath, and rectus muscle with chocolate-colored fluid (Case 2), and 3 cm × 3 cm excised with clear margin (Case 3).
  • Treatment was wide local excision; Case 2 also required mesh repair. All patients were asymptomatic at follow-up (Case 1 at 2 and 6 months, Case 2 for 2 years, Case 3 for 3 years), with no reported relapse or recurrence.

Methods

  • Design: retrospective case series of three patients with scar endometriosis managed at the authors’ hospital.
  • Data: clinical history and examination, ultrasound, MRI in one case, FNAC in one case, surgical findings, histopathology, and follow-up.
  • Analysis: descriptive reporting of individual cases and a summary table; no comparative or statistical analysis.

Limitations

  • The paper does not state limitations.
  • Evident from the text: the series includes only three cases, limiting generalizability.
  • Evident from the text: imaging and FNAC were not uniformly performed and were often inconclusive, so diagnostic conclusions rely mainly on clinical suspicion and histopathology.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.mjafi.2016.07.002

Cites

18 of 18 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 13 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    In this case series, the time interval between surgery and clinical presentation of scar endometriosis varied from 2 years to 12 years.

    “In our case series, this duration varied from 2 years to 12 years.”
    Quote in the paperNot a substantial claim
  • Findingown data

    All patients in this case series had cyclical variation of their symptoms.

    “All our patients had cyclical variation of their symptoms.”
    Quote in the paperNot a substantial claim
  • Findingown data

    All cases in this series had occurrence of scar endometriosis in a post-cesarean scar.

    “All our cases had occurrence of SE in post-cesarean scar.”
    Quote in the paperSubstantial claim
  • Findingown data

    Histopathological examination has been the only definitive and confirmatory diagnostic tool for all three cases in this series.

    “HPE has been the only definitive and confirmatory diagnostic tool for all of our three cases.”
    Quote in the paperSubstantial claim
  • Premisecitation

    Scar endometriosis is extremely rare.

    “Scar endometriosis (SE), although described in literature, is extremely rare.1,2”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [1] source

      Not checked in the free run.

    • cites [2] source

      Not checked in the free run.

  • May combine two claims. 4
  • Classified as probably not a substantial claim. 7
  • May combine two claims.

    Findingown data

    MRI was done in only one patient in this series and the radiological feature was consistent with scar endometriosis.

    “MRI has been done in only one of our patients and the radiological feature was consistent with SE.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    In this case series, surgical treatment was effective with no relapse or recurrence of symptoms.

    “We followed up all three cases and found surgical treatment to be effective with no relapse or recurrence of symptoms.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Ultrasound and FNAC did not help in arriving at a diagnosis in this case series.

    “Ultrasound and FNAC (done in 1st case) did not help us in arriving at a diagnosis.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    An increase in the frequency of endometrioma has been reported in proportion to the increasing number of cesarean sections in recent years.

    “An increase in the frequency of endometrioma has been reported in proportion to the increasing number of CS in recent years.7”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    About 20% of cases of scar endometriosis present with a history of variation in pain intensity with the menstrual cycle.

    “About 20% of cases present with history of variation in pain intensity with menstrual cycle.9”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Kinkel et al. revealed the sensitivity and specificity of MRI in diagnosing endometriomas to be 90-92% and 91-98%, respectively.

    “Kinkel et al. revealed the sensitivity and specificity of MRI in diagnosing endometriomas to be 90-92% and 91-98%, respectively.13”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Post-hysterotomy incidence of scar endometriosis is higher possibly due to pluripotential capabilities of early decidua.

    “Post-hysterotomy incidence of endometriosis in scar is higher possibly due to pluripotential capabilities of early decidua.3”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The time interval between surgery and clinical presentation of scar endometriosis varies from 3 months to 10 years.

    “The time interval between surgery and clinical presentation varies in different series from 3 months to 10 years.4”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Scar endometriosis involving the abdominal wall is distinctly uncommon.

    “SE involving the abdominal wall, however, is distinctly uncommon.3,4”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [3]

      Not checked in the free run.

    • cites [4] source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    Scar endometriosis is a rare clinical entity that often mimics a variety of clinical conditions and hence presents as a diagnostic dilemma.

    “SE is a rare clinical entity and often mimics a variety of clinical conditions and hence presents as diagnostic dilemma.”
    Quote in the paperSubstantial claim
10 of 10
  • The paper relies on this without support.

    Medical treatment with progestogens, oral contraceptive pills, and danazol is not very effective for scar endometriosis, giving only partial relief and not curing the lesion.

    “Medical treatment with the use of progestogens, oral contraceptive pills, and danazol has not been found to be very effective, giving only partial relief and does not cure the lesion.”
  • The paper relies on this without support.

    Good surgical technique and thorough saline wash of the wound during surgery prevent endometrial implantation in the anterior abdominal wall and subsequent scar endometriosis.

    “We recommend that good surgical technique and due precautions like thorough saline wash of the wound should be exercised during surgery to avoid endometrial implantation in anterior abdominal wall, which otherwise may lead to SE with its associated morbidity.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The estimated incidence of cesarean scar endometriosis is 0.03-0.4%.

    “Cesarean scar endometriosis is the most common abdominal wall endometriosis, with an estimated incidence of 0.03–0.4% [4,5,6,7,8].”

    From Scar Endometriosis: A Rare Cause of Abdominal Pain (2022) · cites this paper as [6]

  • Medical therapy such as Gn-RH agonist, Progesterone, oral contraceptive pills, and danazol have been tried, but they only allow partial relief and cause recurrence quickly.

    “Medical therapy such as Gn-RH agonist, Progesterone, oral contraceptive pills, and danazol have been tried, but they only allow partial relief and cause recurrence quickly [3,6,15].”

    From Scar Endometriosis: A Rare Cause of Abdominal Pain (2022) · cites this paper as [6]

  • The definite treatment for scar endometriosis is surgical excision with at least 5-10 mm free margin of surrounding healthy tissue.

    “The definite treatment is surgical excision with at least 5–10 mm free margin of surrounding healthy tissue.”

    From Scar Endometriosis: A Rare Cause of Abdominal Pain (2022) · cites this paper as [6]

  • Ultrasonography, CT, and MRI might help establish a diagnosis and facilitate surgical excision but are not diagnostic.

    “Other modalities, such as Ultrasonography, Computed Tomography (CT), and Magnetic Resonance Imaging (MRI), might help establish a diagnosis and facilitate surgical excision but not diagnostics [3,6,7,14].”

    From Scar Endometriosis: A Rare Cause of Abdominal Pain (2022) · cites this paper as [6]

  • The duration for the occurrence of clinical symptoms of scar endometriosis varies from 3 months to 15 years.

    “Although the duration for the occurrence of clinical symptoms varies from 3 months to 15 years, in our case, it occurred 8 months after the second LSCS surgery [6].”

    From Scar Endometriosis: A Rare Cause of Abdominal Pain (2022) · cites this paper as [6]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Case 1 examination size differs from Table 1

    Minor

    The case description measures the umbilical swelling as 1.5 cm by 2 cm, while Table 1 gives the Case 1 examination finding as 1 cm by 2 cm.

  • Case 1 surgical mass size differs from Table 1

    Minor

    The case description reports a 4 cm by 3 cm mass at surgery; Table 1 reports a 5 cm by 4 cm mass for the same case.

  • Conflicting accounts of whether ultrasound aided Case 1 diagnosis

    Minor

    The case description says the diagnosis was based partly on USG findings, but the discussion says ultrasound did not help arrive at the diagnosis.

3 of 3

Cites

Flagged first, then by citations

1 of the 19 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Authors
Tangri, M. K., Lele, P., Bal, H., Tewari, R., & Majhi, D.
Affiliations
  • Southern Command Hospital (IN)
  • Dr. D. Y. Patil Medical College, Hospital and Research Centre (IN)
  • Armed Forces Medical College (IN)
Corresponding author
Tangri, M.K.
Venue
Medical Journal Armed Forces India
Publisher
Elsevier BV
Published
2016-12
Volume
72
Issue
Suppl 1
Pages
S185-S188
ISSN
0377-1237 (ISSN-L)
OpenAlex
W2508081071
Cited by
18
References
19
Citations by year
2025: 3 · 2024: 4 · 2023: 4 · 2022: 4 · 2019: 1 · 2018: 1 · 2017: 1
FWCI
1.33
Type
journal article
Language
en
Open access
Locations
  • Medical Journal Armed Forces India (publishedVersion)
  • PubMed Central (publishedVersion)
  • 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, abdominal wall mass, dysmenorrhea, surgical gloves, surgical site complications, surgical excision

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

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