Recurrent abdominal wall endometriosis at the trocar site of laparoscopy: A rare case
Open accessAbstract
BACKGROUND: Surgical scar endometriosis is typically presented as a slow-growing, painful abdominal mass near the site of a past surgery. Endometriosis on the trocar port site is rare. To best of our knowledge, only 17 cases have been reported in the literature. The nonspecific nature of endometriosis presents a diagnostic challenge, and it is often considered as an incisional hernia or other conditions. CASE: Here, we described our experience with a recurrent abdominal scar endometriosis case at the trocar port site of a previous laparoscopy, which was initially thought to be an incisional hernia. CONCLUSION: Abdominal wall endometriosis should be considered as an important differential diagnosis in females with a positive history of prior abdominal surgery, presented with painful nodule or mass at the site of the surgery.
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Scar endometriosis is generally considered to result from the direct implantation of endometrial cells into the abdominal fascia or subcutaneous tissue during surgical procedures, with subsequent stimulation by estrogen promoting their growth.
“Scar endometriosis is generally considered to result from the direct implantation of endometrial cells into the abdominal fascia or subcutaneous tissue during surgical procedures, with subsequent stimulation by estrogen promoting their growth [8].”
From Umbilical port-site endometriosis: a case presentation and narrative review of the literature (2026) · cites this paper as [8]
It is widely accepted that surgical removal of a margin of 5-10 mm of healthy tissue around the lesion is necessary to minimize the risk of recurrence.
“It is widely accepted that surgical removal of a margin of 5–10 mm of healthy tissue around the lesion is necessary to minimize the risk of recurrence [8].”
From Umbilical port-site endometriosis: a case presentation and narrative review of the literature (2026) · cites this paper as [8]
Incisional endometriosis after laparoscopy is very rare.
“Incisional endometriosis after laparoscopy is very rare, and if occurring, it is often seen in the cannula incision of that collected specimen.”
From Laparoscopic umbilical trocar port site endometriosis: A case report (2020) · cites this paper as [5]
Many cases of AWE are misdiagnosed as hernia, and one case was misdiagnosed as umbilical granuloma.
“It has been reported that many cases are misdiagnosed as hernia[5,12], and one case was misdiagnosed as umbilical granuloma[13].”
From Laparoscopic umbilical trocar port site endometriosis: A case report (2020) · cites this paper as [5]
Most scholars agree that the etiology of scar endometriosis is endometrial cell planting during surgical treatment.
“Most scholars agree that the etiology of scar endometriosis is endometrial cell planting during surgical treatment[1,5].”
From Laparoscopic umbilical trocar port site endometriosis: A case report (2020) · cites this paper as [5]
According to Akbarzadeh-Jahromi et al, there have been 17 cases of laparoscopic incision endometriosis reported in the English literature.
“According to Akbarzadeh-Jahromi et al[5], there have been 17 cases reported in the English literature.”
From Laparoscopic umbilical trocar port site endometriosis: A case report (2020) · cites this paper as [5]
Surgical excision of normal tissue 5-10 mm away from the edge of the lesion is required to prevent recurrence.
“It is widely accepted that surgical excision is the most appropriate approach, and surgical excision of normal tissue 5-10 mm away from the edge of the lesion is required to prevent recurrence, according to the literature[3,5].”
From Laparoscopic umbilical trocar port site endometriosis: A case report (2020) · cites this paper as [5]
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Cites
Abdominal wall endometriosis: 12 years of experience at a large academic institution
Ecker, A. M., Donnellan, N. M., Shepherd, J. P., & Lee, T. T. M. (2014) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2014.04.011 · Cited by 121 · see citing works
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Scar Endometriosis: A Case Report of This Uncommon Entity and Review of the Literature
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Sonographic features of abdominal wall endometriosis.
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Clinical manifestations of abdominal wall endometriosis: a single center experience
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Abdominal Wall Endometriosis: Report Of A Case And How Much We Know About It?
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Endometrioma of the abdominal wall masquerading as hernia
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Abdominal wall endometriosis (a narrative review)
Carsote, M., Terzea, D. C., Valea, A., & Gheorghisan-Galateanu, A.-A. (2020) · International Journal of Medical Sciences · doi:10.7150/ijms.38679 · Cited by 111 · see citing works
Abdominal wall endometriosis: report of 83 cases
Benedetto, C., Cacozza, D., de Sousa Costa, D., Coloma Cruz, A., Tessmann Zomer, M., Cosma, S., Trippia, C. H., Santos Cavalcanti, T. C., Alves Castro, G. R., & Kondo, W. (2022) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.14167 · Cited by 49 · see citing works
Mixed endometrioid and clear cell carcinoma arising from laparoscopic trocar site endometriosis
Tsuruga, T., Hirata, T., Akiyama, I., Matsumoto, Y., Oda, K., Fujii, T., & Osuga, Y. (2019) · Journal of Obstetrics and Gynaecology Research · doi:10.1111/jog.14014 · Cited by 13 · see citing works
Laparoscopic umbilical trocar port site endometriosis: A case report
Ao, X., Xiong, W., & Tan, S.-Q. (2020) · World Journal of Clinical Cases · doi:10.12998/wjcc.v8.i8.1532 · Cited by 7 · see citing works
Rahman, N. A., & Shope, T. (2022) · PubMed · doi:10.1093/jscr/rjac498 · Cited by 2 · see citing works
“They are thought to occur via direct inoculation of endometrial cells into the abdominal fascia or subcutaneous tissue secondary to surgical intervention [2].”
BackgroundUmbilical port-site endometriosis: a case presentation and narrative review of the literature
Sadlecki, P., Dejewska, K., & Walentowicz-Sadlecka, M. (2026) · Open Medicine · doi:10.1515/med-2026-1411
“Scar endometriosis is generally considered to result from the direct implantation of endometrial cells into the abdominal fascia or subcutaneous tissue during surgical procedures, with subsequent stimulation by estrogen promoting their growth [8].”
- Authors
- Akbarzadeh-Jahromi, M., Maternal-Fetal Medicine Research Center, P. D., Motavas, M., Pathology Department, S. U. O. M. S., Fazelzadeh, A., & Shiraz University of Medical Sciences, S.
- Affiliations
- Shiraz University of Medical Sciences (IR)
- Venue
- International Journal of Reproductive BioMedicine
- Publisher
- Knowledge E DMCC
- Published
- 2018-10-01
- Volume
- 16
- Issue
- 10
- Pages
- 653-656
- ISSN
- 1680-6433 (ISSN-L)
- 2476-4108
- 2476-3772
- PMC
- PMC6314640
- OpenAlex
- W2906350787
- Cited by
- 9
- References
- 10
- Citations by year
- 2026: 1 · 2022: 4 · 2021: 1 · 2020: 2 · 2019: 1
- FWCI
- 1.07
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- International Journal of Reproductive BioMedicine (IJRM) (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Keywords
- abdominal wall endometriosis, recurrent endometriosis, laparoscopic surgery complications
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