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Cited by 33Endometriosis Research and TreatmentEctopic Pregnancy Diagnosis and ManagementGynecological conditions and treatments

5-Year data analysis of patients following abdominal wall endometrioma surgery

Open access
Khamechian, Tahere, Alizargar, Javad, Mazoochi, Tahere·2014·BMC Women's Health
DOI 10.1186/s12905-014-0151-4PMC PMC4263010
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Abstract

BACKGROUND: Endometriosis is a disorder in which an ectopic endometrial tissue grows outside the uterine cavity. The ectopic endometrium embedded in the subcutaneous fatty layer and the muscles of abdominal wall is called as abdominal wall endometriosis (AWE). AWE is a rare condition; however, it is usually known to develop along with previous surgical scars. Caesarean section and hysterectomy are considered to be commonly associated with the development of AWE. METHODS: We evaluated the data of the patients who underwent AWE surgery between March 2009 and March 2014. RESULTS: The mean age of the patients was 32.5 years. We found a previous history of caesarean section in all of the patients. The most frequent symptoms of the patients were abdominal mass sensation and abdominal pain. Invasion of endometriosis to fat layer, fascia, muscular layer, and peritoneum was recorded. Three masses were located within the scar regions. CONCLUSIONS: We can conclude that there is a high prevalence of caesarean sections among the women with AWE.

AI snapshot

Written from the paper’s full text.

TL;DR

In a five-year single-center series of 30 patients with histologically confirmed abdominal wall endometriosis (AWE), all had a prior caesarean section and all presented with a mass. The authors conclude that AWE is strongly associated with caesarean section and may become more frequent as caesarean section rates rise.

Key findings

  • The mean age was 32.5 ± 8.24 years (range 23–67). All 30 patients had a previous caesarean section: 11 (36.6%) had one, 14 (46.7%) had two, and 5 (16.7%) had three.
  • All patients had a mass; 24 (80%) had pain, including 14 (46.7%) with cyclic pain and 10 (33.3%) with noncyclic pain. Mean symptom duration was 12.7 ± 10.44 months (range 3–45), and mean time from previous surgery to AWE diagnosis was 30.5 ± 12.65 months.
  • Ultrasonography was used in 28 patients (93.3%); 27 (90%) had a single mass and 3 (10%) had two masses. Initial diagnosis was AWE in 19 patients (63.3%), while 11 (36.7%) were initially misdiagnosed.
  • Mass location was in or under the previous surgical scar in 21 patients (70%), including 3 (10%) within the scar. Mean mass diameter was 2.59 ± 1.21 cm (range 1–6 cm). One patient had a recurrent mass after six months; no malignancy was reported.

Methods

  • The study evaluated data from patients who underwent surgery for AWE between March 2009 and March 2014 at Shahid Beheshti Hospital, with institutional review board approval from Kashan University of Medical Sciences.
  • Data collected included age, parity, related past medical history, chief complaint, exact site of AWE, and postoperative information. Histological confirmation required at least two of three features: endometrial stroma, endometrial-like glands, and hemosiderin pigment.
  • Thirty patients with histopathologically confirmed AWE were included; the analysis reports descriptive frequencies, percentages, ranges, and means.

Limitations

  • The paper states that fine-needle aspiration cytology was not performed in this study.
  • No formal limitations section is provided; evident from the text, this is a single-center case series of 30 patients with no control or comparison group.
  • Follow-up duration is not specified beyond one recurrence detected at six months, and no malignancy was reported, so long-term outcomes and malignant transformation risk cannot be assessed from these data.

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

Integrity signals

Registry

Crossref · 10.1186/s12905-014-0151-4

Cites

19 of 19 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 31 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    All patients in the study had a previous history of caesarean section.

    “We found a previous history of caesarean section in all of the patients.”
    Quote in the paperNot a substantial claim
  • Findingown data

    No case of malignancy was reported among the study patients.

    “No case of malignancy was reported among our study patients.”
    Quote in the paperNot a substantial claim
  • Findingown data

    The study included 30 patients who underwent surgery for abdominal wall endometriosis (AWE).

    “the data of 30 patients who underwent AWE surgery were entered in our study.”
    Quote in the paperSubstantial claim
  • Findingown data

    All patients had a notable mass as a presenting symptom.

    “All patients had a notable mass as a presenting symptom.”
    Quote in the paperNot a substantial claim
  • Findingown data

    The mean time between the previous surgery and diagnosis of AWE was 30.5 ± 12.65 months.

    “The mean time between the previous surgery and diagnosis of AWE was 30.5 ± 12.65 months.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 25
  • Classified as probably not a substantial claim. 40

  • May combine two claims.

    Findingown data

    The masses were located in or under the scar of the previous surgery in 21 patients (70%), with three cases located in the scar; hypochondrium away from the scar and umbilicus each in four cases (13.3%), and groin region in one case (3.3%).

    “The location of the masses was in or under the scar of the previous surgery in 21 patients (70%) (in three cases the mass was located in the scar), hypochondrium away from the scar and umbilicus each in four cases (13.3%), and groin region in one case (3.3%).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    The mean duration of symptoms was 12.7 ± 10.44 months, ranging from three to forty-five months.

    “The mean duration of symptoms was 12.7 ± 10.44 months, ranging from three to forty-five months.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    The mean diameter of the masses was 2.59 ± 1.21 cm, ranging between 1 cm and 6 cm.

    “The mean diameter of the masses was 2.59 ± 1.21 cm, ranging between 1 cm and 6 cm.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Two patients (6.7%) had dyspareunia, three (10%) had dysmenorrhea, and one (3.3%) had bleeding as presenting symptoms.

    “Two patients (6.7%) had dyspareunia, three (10%) had dysmenorrhea, and one (3.3%) had bleeding as presenting symptoms.”
    Quote in the paperNot a substantial claim

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

    Findingreasoning

    All the patients had at least two features of endometrioma.

    “All the patients had at least two features of endometrioma.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Four patients did not have any symptoms and AWE was discovered during caesarean sections.

    “Four patients did not have any symptoms and AWE was discovered during the caesarean sections.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Nine cases (30%) had a mass in the fat tissue, fourteen (46.7%) in muscle tissue, eleven (36.7%) in the fascia of the abdomen muscles, ten (33.3%) in the omentum, and one (3.3%) in the dermis.

    “Nine cases (30%) had a mass in the fat tissue, fourteen (46.7%) in muscle tissue, eleven (36.7%) in the fascia of the abdomen muscles, ten (33.3%) in the omentum, and one (3.3%) in the dermis.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Among the patients, 11 (36.6%) had one caesarean section, 14 (46.7%) had two, and 5 (16.7%) had three.

    “Eleven patients (36.6%) had a single caesarean section. Fourteen patients (46.7%) had two caesarean sections and five (16.7%) had three caesarean sections.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Twenty-seven patients (90%) had a single mass, whereas three (10%) had two masses at the time of diagnosis.

    “Twenty-seven patients (90%) had a single mass, whereas, three (10%) had two masses at the time of diagnosis.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Hematoma was observed in one patient (3.3%) and necrosis in two patients (6.7%).

    “Hematoma and necrosis were observed in one (3.3%) and two patients (6.7%), respectively.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    CT scan and MRI were the least used diagnostic methods in the study.

    “CT scan and MRI were the least used methods.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    One patient was diagnosed with a recurred mass after six months, which was removed with clear margins.

    “All the patients underwent follow-up tests and one patient was diagnosed with a recurred mass after six months, which was removed with clear margins.”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    Not all endometriosis patients had cyclic symptoms.

    “Not all of the endometriosis patients had cyclic symptoms.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    The patients' ages ranged from 23 to 67 years, with a mean age of 32.5 ± 8.24 years.

    “The age of the patients ranged from 23 to 67 years. The mean age of the patients was 32.5 ± 8.24 years.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Eight patients (26.7%) had surgeries other than caesarean section, including one myomectomy, three hysterectomies, one tubalectomy, and three appendectomies.

    “Eight patients (26.7%) had surgeries other than caesarean section. These surgeries include one myomectomy, three hysterectomies, one tubalectomy, and three appendectomies.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Ultrasonography was used to diagnose AWE in 28 patients (93.3%), CT in five (16.6%), and MRI in two (6.6%).

    “In 28 patients (93.3%), the ultrasonography was used to diagnose AWE, computed tomography (CT) scan and magnetic resonance imaging (MRI) were used in five (16.6%) and two (6.6%) patients, respectively.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In nineteen patients (63.3%), the initial diagnosis was AWE; abdominal wall tumour was diagnosed in four (13.3%), incisional hernia in three (10%), suture granuloma in two (6.7%), and inguinal hernia and desmoid tumour each in one (3.3%).

    “In nineteen patients (63.3%), the initial diagnosis was AWE, whereas abdominal wall tumour was diagnosed in four patients (13.3%), incisional hernia in three (10%) cases, suture granuloma in two cases (6.7%), and inguinal hernia and desmoid tumour each in one case (3.3%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Twenty-four patients (80%) experienced pain, and 14 of them (46.7%) experienced cyclic pain.

    “Other than the mass, 24 patients (80%) experienced pain, among whom 14 patients (46.7%) experienced cyclic pain.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    The patients' number of parities ranged from one to four.

    “Their number of parities ranged from one to four.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Histological confirmation of endometrioma is based on detecting at least two of three features: endometrial stroma, endometrial-like glands, and hemosiderin pigment.

    “Histological confirmation of endometrioma is based on detecting at least two of the three following features: endometrial stroma, endometrial like glands and hemosiderin pigment [10].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [10] Dwivedi AJ, Agrawal SN, Silva YJ: Abdominal wall endometriomas. Dig Dis Sci. 2002, 47: 456-461. 10.1023/A:1013711314870. [PMID 11855568] source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    The fact that all patients in the study had undergone caesarean section, and some had other gynecological surgeries, may favor the transport theory.

    “The fact that all the patients of our study had undergone a cesarean section, and some had other gynecological surgeries may be in favor of transport theory.”
    Quote in the paperSubstantial claim

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

    Premisecitation

    Caesarean section and hysterectomy are commonly associated with the development of AWE.

    “Caesarean section and hysterectomy are considered to be commonly associated with AWE”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] Bektaş H, Bilsel Y, Sari YS, Ersöz F, Koç O, Deniz M, Boran B, Hug GE: Abdominal wall endometrioma; a 10-year experience and brief review of the literature. J Surg Res. 2010, 164 (1): e77-e81. 10.1016/j.jss.2010.07.043. [PMID 20855082] doi: 10.1016/j.jss source

      Not checked in the free run.

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

    Premisecitation

    The most prevalent clinical feature of endometriosis includes a painful mass with cyclic pain that exacerbates with menstruation.

    “the most prevalent clinical feature of endometriosis includes a painful mass with a cyclic pain that exacerbates with menstruation [4].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] Bektaş H, Bilsel Y, Sari YS, Ersöz F, Koç O, Deniz M, Boran B, Hug GE: Abdominal wall endometrioma; a 10-year experience and brief review of the literature. J Surg Res. 2010, 164 (1): e77-e81. 10.1016/j.jss.2010.07.043. [PMID 20855082] doi: 10.1016/j.jss source

      Not checked in the free run.

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

    Premisecitation

    Endometriosis can be categorized as a steroid-dependent disease.

    “Endometriosis can be categorized as a steroid-dependant disease [13].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Lattuada D, Somigliana E, Viganò P, Candiani M, Pardi G, Di Blasio AM: Genetics of endometriosis: a role for the progesterone receptor gene polymorphism PROGINS?. Clin Endocrinol (Oxf). 2004, 61: 190-194. 10.1111/j.1365-2265.2004.02076.x. source

      Not checked in the free run.

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

    Premisecitation

    The surgical scar of caesarean section is the most common site for extrapelvic endometriosis known as caesarean scar endometriosis, with an incidence of 0.07%-0.47%.

    “the surgical scar of the caesarean section is the most common site for extra pelvic endometriosis known as caesarean scar endometriosis with the incidence of 0.07%–0.47% [4]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] Bektaş H, Bilsel Y, Sari YS, Ersöz F, Koç O, Deniz M, Boran B, Hug GE: Abdominal wall endometrioma; a 10-year experience and brief review of the literature. J Surg Res. 2010, 164 (1): e77-e81. 10.1016/j.jss.2010.07.043. [PMID 20855082] doi: 10.1016/j.jss source

      Not checked in the free run.

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

    Interpretationreasoning

    The transport theory cannot explain why endometrial tissues can survive and proliferate in new sites.

    “some other features of endometriosis, like why the endometrial tissues can survive and proliferate in the new sites cannot be explained with the transport theory.”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    Oestrogen can be further produced in endometrial lesions by aromatase activity.

    “The oestrogen can be further produced in the endometrial lesions by aromatase activity [14].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14] Bulun SE, Imir G, Utsunomyia H, Thung S, Gurates B, Tamura M, Lin Z: Aromatase in endometriosis and uterine leiomyomata. J Steroid Biochem Mol Biol. 2005, 95: 57-62. 10.1016/j.jsbmb.2005.04.012. source

      Not checked in the free run.

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

    Premisecitation

    The transport theory explains that direct inoculation or transport of endometrial tissue into surgical scars or adjacent tissues during surgery is responsible for AWE.

    “The transport theory explains that direct inoculation or transport of the endometrial tissue into the surgical scars or adjacent tissues during the surgery is responsible for AWE.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [8] Ding Y, Zhu J: A retrospective review of abdominal wall endometriosis in Shanghai, China. I J Gynecol Obstet. 2013, 121 (1): 41-44.

      Not checked in the free run.

    • cites [10] Dwivedi AJ, Agrawal SN, Silva YJ: Abdominal wall endometriomas. Dig Dis Sci. 2002, 47: 456-461. 10.1023/A:1013711314870. [PMID 11855568] source

      Not checked in the free run.

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

    Premisecitation

    The diagnosis of endometriosis might be challenging, and several differential diagnoses might exist for a mass in the abdominal wall, including desmoid tumour, fibrosis, suture granuloma, fat necrosis, nodular fasciitis, and primary or metastatic malignancies.

    “The diagnosis of this disease might be challenging and several differential diagnoses might exist for a mass in the abdominal wall, including desmoid tumour, fibrosis, suture granuloma, fat necrosis, nodular fasciitis and primary or metastatic malignancies lesions [15].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] Pathan ZA, Dinesh U, Rao R: Scar endometriosis. J Cytol. 2010, 27: 106-108. 10.4103/0970-9371.71877. source

      Not checked in the free run.

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

    Premisecitation

    In metaplasia theory, primitive pleuropotential mesenchymal cells that have undergone differentiation metaplasia are said to cause AWE.

    “In metaplasia theory, primitive pleuropotential mesenchymal cells that have gone under differentiation metaplasia are said to cause AWE.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [8] Ding Y, Zhu J: A retrospective review of abdominal wall endometriosis in Shanghai, China. I J Gynecol Obstet. 2013, 121 (1): 41-44.

      Not checked in the free run.

    • cites [10] Dwivedi AJ, Agrawal SN, Silva YJ: Abdominal wall endometriomas. Dig Dis Sci. 2002, 47: 456-461. 10.1023/A:1013711314870. [PMID 11855568] source

      Not checked in the free run.

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

    Interpretationreasoning

    The transport theory might explain that endometrial tissues can be iatrogenically transported into the abdominal wall or into the scars of surgery.

    “This theory might explain that endometrial tissues can be iatrogenically transported into the abdominal wall or into the scars of the surgery.”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    AWE is considered very rare, with an overall prevalence of around 0.01-1% after caesarean section.

    “AWE is considered very rare with the overall prevalence of around 0.01–1% after caesarean section [10].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] Dwivedi AJ, Agrawal SN, Silva YJ: Abdominal wall endometriomas. Dig Dis Sci. 2002, 47: 456-461. 10.1023/A:1013711314870. [PMID 11855568] source

      Not checked in the free run.

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

    Premisecitation

    Although the prevalence of endometriosis in adult women is not completely known, it is said to occur in 5%-10%.

    “Although its prevalence in adult women is not completely known, it is said to occur in 5%–10% [3].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] Giudice LC, Kao LC: Endometriosis. Lancet. 2004, 364: 1789-10.1016/S0140-6736(04)17403-5. source

      Not checked in the free run.

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

    Premisecitation

    AWE is often mistaken for surgical conditions such as abscess, lipoma, or incisional hernia.

    “AWE is often mistaken with some surgical conditions like abscess, lipoma or incisional hernia [11].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11] Goel P, Devi L, Tandon R, Saha PK, Dalal A: Scar endometriosis - a series of six patients. Int J Surg. 2011, 9 (1): 39-40. 10.1016/j.ijsu.2010.08.003. [PMID 20804870] doi: 10.1016/j.ijsu source

      Not checked in the free run.

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

    Premisecitation

    The most common type of malignancy associated with endometriosis is clear-cell carcinoma.

    “the most common type is clear-cell carcinoma.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] Ding Y, Zhu J: A retrospective review of abdominal wall endometriosis in Shanghai, China. I J Gynecol Obstet. 2013, 121 (1): 41-44.

      Not checked in the free run.

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

    Study design and conductnone given

    The study has complete approval by the institutional review board of Kashan University of Medical Sciences.

    “This study has complete approval by the institutional review board of Kashan University of Medical Sciences.”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    Clear-cell carcinoma has a 5-year survival of 80%.

    “This neoplasm has 5-year survival of 80% [8].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] Ding Y, Zhu J: A retrospective review of abdominal wall endometriosis in Shanghai, China. I J Gynecol Obstet. 2013, 121 (1): 41-44.

      Not checked in the free run.

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

    Premisecitation

    AWE is a rare condition, but it is usually known to develop along with previous surgical scars.

    “AWE is a rare condition; however, it is usually known to develop along with previous surgical scars.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [4] Bektaş H, Bilsel Y, Sari YS, Ersöz F, Koç O, Deniz M, Boran B, Hug GE: Abdominal wall endometrioma; a 10-year experience and brief review of the literature. J Surg Res. 2010, 164 (1): e77-e81. 10.1016/j.jss.2010.07.043. [PMID 20855082] doi: 10.1016/j.jss source

      Not checked in the free run.

    • cites [7] Marsden NJ, Wilson-Jones N: Scar endometriosis: a rare skin lesion presenting to the plastic surgeon. J Plast Reconstr Aesthet Surg. 2013, 66 (4): e111-e113. 10.1016/j.bjps.2012.12.024. [PMID 23369738] doi: 10.1016/j.bjps source

      Not checked in the free run.

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

    Premisecitation

    Extrapelvic occurrence of endometriosis is rare and occurs more commonly in the abdominal wall, followed by umbilicus, vulva, appendix, ileum, hernia sac, and colon.

    “The extrapelvic occurrence of endometriosis is rare and it occurs more commonly in abdominal wall followed by umbilicus, vulva, appendix, ileum, hernia sac, and colon [5].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5] García-Santos EP, Muñoz-Atienza V, Sánchez-García S, Puerto-Puerto A, Ruescas-García FJ, Manzanares-Campillo MC, Martínez-de Paz F, Padilla-Valverde D, Vitón-Herrero R, González-López L: Endometriosis de localización extraovárica. Nuestra casuística en 10 años. Progresos de Obstetricia y Ginecología. 2014, 57 (3): 117-120. 10.1016/j.pog.2013.10.003. doi: 10.1016/j.pog.2013.10.003 source

      Not checked in the free run.

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

    Study design and conductown data

    Written informed consent was obtained from the patients.

    “After obtaining written informed consent”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    There are some reports of clear-cell carcinoma associated with AWE.

    “Although there are some reports of clear-cell carcinoma associated with AWE [18]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] Yan Y, Li I, Guo J, Zheng Y, Liu Q: Malignant transformation of an endometriotic lesion derived from an abdominal wall scar. Int J Gynecol Obstet. 2011, 115 (2): 202-203. 10.1016/j.ijgo.2011.06.018. source

      Not checked in the free run.

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

    Premisecitation

    The risk of malignancy transformation of endometriosis is not known, and less than 1% of endometriosis patients are reported to develop associated neoplasms.

    “Although the risk of malignancy transformation of endometriosis is not known and less than 1% of endometriosis patients are reported to develop associated neoplasms”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] Ding Y, Zhu J: A retrospective review of abdominal wall endometriosis in Shanghai, China. I J Gynecol Obstet. 2013, 121 (1): 41-44.

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    As caesarean section rates become more frequent and there is a high prevalence of caesarean section among women with AWE, higher rates of AWE may be encountered in the future.

    “As caesarean section rates are becoming more frequent, and there is a high prevalence of caesarean section among women with AWE, we may encounter higher rates of this uncommon entity in the future.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The 30 patients who underwent AWE surgery at Shahid Beheshti Hospital are representative of women with AWE generally.
    • Rests on an assumption: The patients' reported history of caesarean section is accurate.

  • May combine two claims.

    Interpretationown data

    AWE can occur after gynaecological surgeries and caesarean sections, especially near or within scars.

    “it can occur after gynaecological surgeries and caesarean sections especially near or within the scars.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The 30 patients who underwent AWE surgery at Shahid Beheshti Hospital are representative of women with AWE generally.

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

    Premisecitation

    Series of one, five, and six scar endometriosis cases had been reported earlier.

    “The series of one, five, and six scar endometriosis had been reported earlier [11,16,17].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [11] Goel P, Devi L, Tandon R, Saha PK, Dalal A: Scar endometriosis - a series of six patients. Int J Surg. 2011, 9 (1): 39-40. 10.1016/j.ijsu.2010.08.003. [PMID 20804870] doi: 10.1016/j.ijsu source

      Not checked in the free run.

    • cites [16] Nissotakis C, Zouros E, Revelos K, Sakorafas GH: Abdominal wall endometrioma: a case report and review of the literature. ARON J. 2010, 91 (6): 730-745. 10.1016/j.aorn.2010.01.014. source

      Not checked in the free run.

    • cites [17] Akdemir A, Akman L, Tore Yavuzsen H, Zekioglu O: Clinical features of the patients with endometriosis on the cesarean scar. Kaohsiung J Med Sci. 2014, 30 (10): 541-543. 10.1016/j.kjms.2013.12.001. source

      Not checked in the free run.

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

    Premisecitation

    Endometriosis is known to develop spontaneously and is usually found near or at the site of scars of surgeries such as hysterectomies, caesarean sections, laparoscopies, tubal ligations, and episiotomies.

    “It is known to develop spontaneously [6] and is usually found near or at the site of scars of surgeries like hysterectomies, caesarean sections, laparoscopies, tubal ligations, and episiotomies [4,7].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [6] Ideyi SC, Schein M, Niazi M, Gerst PH: Spontaneous endometriosis of the abdominal wall. Dig Surg. 2003, 20 (3): 246-248. 10.1159/000070392. [PMID 12759505] doi:10.1159/000070392 source

      Not checked in the free run.

    • cites [4] Bektaş H, Bilsel Y, Sari YS, Ersöz F, Koç O, Deniz M, Boran B, Hug GE: Abdominal wall endometrioma; a 10-year experience and brief review of the literature. J Surg Res. 2010, 164 (1): e77-e81. 10.1016/j.jss.2010.07.043. [PMID 20855082] doi: 10.1016/j.jss source

      Not checked in the free run.

    • cites [7] Marsden NJ, Wilson-Jones N: Scar endometriosis: a rare skin lesion presenting to the plastic surgeon. J Plast Reconstr Aesthet Surg. 2013, 66 (4): e111-e113. 10.1016/j.bjps.2012.12.024. [PMID 23369738] doi: 10.1016/j.bjps source

      Not checked in the free run.

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

    Study design and conductown data

    All patients underwent follow-up tests.

    “All the patients underwent follow-up tests”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    Fine needle aspiration cytology (FNAC) can be helpful before surgery and can be used for determining all three criteria of endometriosis.

    “Using of fine needle aspiration cytology (FNAC) can be helpful before the surgery and can be used for determining all three criterion of endometriosis [15]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] Pathan ZA, Dinesh U, Rao R: Scar endometriosis. J Cytol. 2010, 27: 106-108. 10.4103/0970-9371.71877. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Histopathological confirmation was used before entering patient data into the study.

    “After histopathological confirmation (Figure 1), the data of 30 patients who underwent AWE surgery were entered in our study.”
    Quote in the paperSubstantial claim

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

    Study design and conductown data

    FNAC was not performed in the study.

    “but it was not performed in our study.”
    Quote in the paperNot a substantial claim
50 of 50

  • The paper relies on this without support.

    The 30 patients who underwent AWE surgery at Shahid Beheshti Hospital are representative of women with AWE generally.

    “We can conclude that there is a high prevalence of caesarean sections among the women with AWE.”

  • The paper relies on this without support.

    The patients' reported history of caesarean section is accurate.

    “We found a previous history of caesarean section in all of the patients.”
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?

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.

  • Parity range differs between Results and Table 1

    Minor

    The Results state that parity ranged from one to four, while Table 1 gives a range of zero to four.

  • Four asymptomatic patients conflict with universal presenting mass

    Minor

    The Results say every patient had a mass as a presenting symptom, but also say four patients had no symptoms and were diagnosed during caesarean sections.

2 of 2

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Related

Authors
Khamechian, T., Alizargar, J., & Mazoochi, T.
Affiliations
Kashan University of Medical Sciences (IR)
ORCID
Alizargar, Javad
Venue
BMC Women's Health
Publisher
Springer Science and Business Media LLC
Published
2014-12
Volume
14
Issue
1
Pages
151-151
ISSN
1472-6874 (ISSN-L)
DOI
10.1186/s12905-014-0151-4
PMC
PMC4263010
OpenAlex
W1990718546
Semantic Scholar
d07d30e9cf367fee16cb0dc529c4a0ea052ae92e
Cited by
33
References
19
Citations by year
2024: 1 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 5 · 2019: 4 · 2018: 9 · 2017: 5 · 2016: 3 · 2015: 1
FWCI
3.64
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Women s Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
Keywords
abdominal wall endometriosis, endometrioma, endometriosis, cesarean section, hysterectomy, postoperative scarring, abdominal mass, abdominal pain, long-term outcomes
MeSH terms
Adult, Aged, Cesarean Section, Cicatrix, Connective Tissue Diseases, Endometriosis, Fascia, Female, Follow-Up Studies, Humans, Middle Aged, Muscular Diseases, Omentum, Skin Diseases, Abdominal Pain, Abdominal Wall, Subcutaneous Fat, Abdominal, Young Adult

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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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