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Cited by 16Endometriosis Research and TreatmentTeratomas and Epidermoid CystsGynecological conditions and treatments

Skin endometriosis: A case report and review of the literature

Open access
Matei, Andreea-Mariana, Draghici‑Ionescu, Ana-Maria, Cioplea, Mirela, Zurac, Sabina, Boda, Daniel, Serban, Ioana, Caruntu, Constantin, Ilie, Mihaela +1 more·2021·Experimental and Therapeutic Medicine
DOI 10.3892/etm.2021.9964PMC PMC8014966
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Abstract

Skin endometriosis is a rare disease with variable clinical and histopathological characteristics that depend on hormonal stimuli. The skin is not a common location, as most cases of endometriosis involve pelvic sites, such as the ovaries, peritoneum and bowel. However, the most common extrapelvic site affected is the abdominal wall and this location of the disease is frequently associated with obstetric and gynecologic surgery. Here we report a case of skin endometriosis emerged as a painful subcutaneous nodule located near to the left side of an obstetrical surgery procedure scar. The patient affected was a woman in her reproductive age, with a history of right ovary endometriotic cyst laparoscopically removed and histologically confirmed as a primary endometriosis. Dermatologists should be aware of this condition in any woman with a painful lump located in the proximity of a pelvic surgery-induced scar. Its non-specific clinical appearance may confuse the clinician and may delay the diagnosis and management.

AI snapshot

Written from the paper’s full text.

TL;DR

Skin endometriosis is a rare, hormonally responsive condition that often presents near pelvic surgery scars and can be misdiagnosed because of nonspecific clinical findings. This paper reports a 29-year-old woman with a painful subcutaneous nodule near a C-section scar, confirmed histologically and immunohistochemically as endometriosis, and reviews the literature on diagnosis and management.

Key findings

  • A 29-year-old woman presented with a painful subcutaneous nodule ~1.5 cm in diameter, located 2 cm superior to the left side of a Pfannenstiel C-section scar; pain worsened prior to menses.
  • She had a history of a right ovarian endometrial cyst laparoscopically removed 4 years earlier, later underwent a second laparoscopy with thermocoagulation and triptorelin 3.75 mg monthly for 5 months, and developed the nodule ~2 years after a term C-section.
  • Histopathology showed glandular structures with simple columnar focal ciliated epithelium surrounded by endometrial stroma, with hematic extravasations and rare siderophages; immunohistochemistry showed estrogen receptor positivity in epithelial nuclei, diffuse intense CD10 positivity in endometrial stroma, and Ki67 positivity in <1% of epithelial cell nuclei.
  • The review cites >300 reported skin endometriosis cases; Stojanovic et al found 210 scar cases, including 119 after C-section. Zhang et al’s 198 Caesarean scar-related cases found >70% in superficial abdominal wall regions, 5.7% in adipose layer, 64.6% between adipose and fascia, and 83% in a Pfannenstiel incision corner; recurrence is described in 6-11% and malignancy in <1% of endometriosis cases.

Methods

  • Design: single case report plus review of existing literature.
  • Case data: a 29-year-old female with a painful lower abdominal wall nodule near a C-section scar; evaluation included medical history, physical examination, surgical excision, routine H&E staining, and immunohistochemistry for CD10, estrogen receptor, and Ki67.
  • Literature review: descriptive synthesis of prior reports and studies on skin/abdominal wall endometriosis, including surgical scar association, imaging, dermoscopy, histopathology, immunohistochemistry, pathophysiology, treatment, recurrence, and malignancy.

Limitations

  • The paper does not state a formal limitations section.
  • Evident from the text: the primary evidence is a single case report, so findings cannot establish generalizable risk factors, diagnostic accuracy, or treatment outcomes.
  • Evident from the text: the literature review is narrative rather than systematic, with no stated search strategy or quality assessment; the paper also notes that standardized dermoscopic features of skin endometriosis have not yet been established.

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

Integrity signals

Registry

Crossref · 10.3892/etm.2021.9964

Cites

38 of 38 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 44 cited sources checked · 0 supported · 0 flagged

  • Findingown data
    § Case report

    The patient presented with a painful nodule located in the inferior abdominal wall.

    “A 29-year-old female presented to the Dermatology Department of 'Prof.Dr. Nicolae C. Paulescu' National Institute of Diabetes, Nutrition and Metabolic Diseases, Bucharest, Romania for the investigation of a painful nodule located in the inferior abdominal wall.”
    Quote in the paperNot a substantial claim
  • Findingown data
    § Skin endometriosis: A case report and review of the literature

    Pathologic report showed adipose connective tissue, neuro-vascular and fascial tissue including multiple glandular structures of variable dimensions with a simple columnar focal ciliated epithelium, surrounded by an endometrial stroma with multiple hematic extravasations and rare siderophages.

    “The pathologic report showed adipose connective tissue, neuro-vascular and fascial tissue including multiple glandular structures of variable dimensions with a simple columnar focal ciliated epithelium, surrounded by an endometrial stroma (Fig. 1) with multiple hematic extravasations and rare siderophages.”
    Quote in the paperSubstantial claim
  • Findingown data
    § Skin endometriosis: A case report and review of the literature

    The patient experienced menstrual cycle-dependent lower abdominal pain after the first surgery.

    “The patient presented menstrual cycle-dependent lower abdominal pain after the first surgery.”
    Quote in the paperNot a substantial claim
  • Findingown data
    § Skin endometriosis: A case report and review of the literature

    The macroscopic aspect of the nodule excluded the diagnosis of a cystic lesion or lipoma.

    “The macroscopic aspect of the nodule excluded the diagnosis of a cystic lesion or lipoma and the specimen was referred to the pathology department for microscopic examination.”
    Quote in the paperNot a substantial claim
  • Findingown data
    § Skin endometriosis: A case report and review of the literature

    A second laparoscopy showed multiple sites of endometriosis.

    “A second laparoscopy was performed, showing multiple sites of endometriosis.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 33
  • May combine two claims. 32

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

    Findingown data
    § Case report

    The patient was a 29-year-old female.

    “A 29-year-old female presented to the Dermatology Department of 'Prof.Dr. Nicolae C. Paulescu' National Institute of Diabetes, Nutrition and Metabolic Diseases, Bucharest, Romania for the investigation of a painful nodule located in the inferior abdominal wall.”
    • Also stated in: § Discussion · plain
      “Our female patient was 29 years of age, thus she was in her reproductive age”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Skin endometriosis: A case report and review of the literature

    Physical examination showed a palpable subcutaneous nodule approximately 1.5 cm in diameter, round, well defined, mobile, tender on palpation, located 2 cm superior to the left side of the C-section scar (Pfannenstiel incision).

    “The physical examination showed a palpable subcutaneous nodule of approximately 1.5 cm in diameter, round, well defined and mobile, tender on palpation, located 2 cm superior to the left side of the C-section scar (Pfannenstiel incision).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data
    § Case report

    The patient had a history of a right ovarian endometrial cyst, laparoscopically removed 4 years prior and pathologically confirmed as primary endometriosis.

    “The patient medical history was significant for a right ovarian endometrial cyst, laparoscopically removed 4 years”
    • Also stated in: § Skin endometriosis: A case report and review of the literature · plain
      “prior to this presentation, and pathologically confirmed as primary endometriosis.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Skin endometriosis: A case report and review of the literature

    Two years after giving birth, the patient presented with a painful nodule in the lower abdominal wall, with pain worsening prior to menses.

    “Two years after giving birth, she presented at our department for a painful nodule (the pain was worsening prior menses), located in the lower abdominal wall.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data
    § Skin endometriosis: A case report and review of the literature

    After 1 year, the patient remains without recurrence of the disease or appearance of endometriosis.

    “After 1 year, the patient remains without recurrence of the disease or appearance of endometriosis.”
    Quote in the paperNot a substantial claim

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

    Findingown data
    § Skin endometriosis: A case report and review of the literature

    The C-section scar was well-healed, supple and whitish, without any pathological finding upon palpation.

    “The C-section scar was well-healed, supple and whitish, without any pathological finding upon palpation.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Skin endometriosis: A case report and review of the literature

    Immunohistochemical testing showed positivity for estrogen receptor in the nuclei of epithelial cells lining glandular structure endometrial-like cells, CD10 diffuse and intense positivity in the endometrial stroma, and Ki67 positivity below 1% of epithelial cell nuclei.

    “The immunohistochemical testing showed positivity for the estrogen receptor in the nuclei of epithelial cells lining glandular structure endometrial-like cells, CD10 diffuse and intense positivity in the endometrial stroma and Ki67 positivity below 1% of epithelial cell nuclei (Fig. 2).”
    Quote in the paperSubstantial claim

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

    Premisecitation
    § Introduction

    In patients with C-sections, the incidence of endometriosis can be as high as 1%.

    “In patients with C-sections, the incidence can be as high as 1% (5).”
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    Premisecitation
    § Introduction

    Endometriosis is characterized by the presence of endometrial stroma outside the uterus, with the same reactivity to hormonal stimuli as normal stroma.

    “endometriosis is characterized by the presence of endometrial stroma outside the uterus, with the same reactivity to hormonal stimuli as the normal stroma (3,5).”
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    Premisecitation
    § Abstract

    The most common extrapelvic site affected by endometriosis is the abdominal wall, and this location is frequently associated with obstetric and gynecologic surgery.

    “However, the most common extrapelvic site affected is the abdominal wall and this location of the disease is frequently associated with obstetric and gynecologic surgery.”
    • Also stated in: § Discussion · plain
      “In regards to skin endometriosis, the most frequent extrapelvic site affected is the abdominal wall and it is associated with obstetric and gynecologic surgery (9).”
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    • cites [9]

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    Premisenone given
    § Abstract

    Skin endometriosis is a rare disease with variable clinical and histopathological characteristics that depend on hormonal stimuli.

    “Skin endometriosis is a rare disease with variable clinical and histopathological characteristics that depend on hormonal stimuli.”
    • Also stated in: § Discussion · plain
      “Skin endometriosis is a rare disorder with variable clinical and histopathological appearance that depends on hormonal stimuli and it primarily affects women of reproductive age.”
    Quote in the paperNot a substantial claim

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

    Premisecitation
    § Introduction

    Endometriosis can be primary or secondary/iatrogenic following obstetric and gynecological procedures, of which C-section is the most frequent.

    “The disease can be primary, where the endometrial tissue is found outside the uterus without any external intervention and secondary or iatrogenic, following obstetric and gynecological procedures (uterine wall opening), of which Caesarean-section (C-section) is the most frequent (4).”
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    Premisecitation
    § Introduction

    The most frequent symptom of endometriosis is cyclic pain, and a positive history for surgery may be a clue for diagnosis.

    “However, the most frequent symptom is cyclic pain and a positive history for surgery may be a clue for the correct diagnosis (5,7).”
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    Premisecitation
    § Discussion

    More than 300 cases of skin endometriosis have been described in the literature.

    “More than 300 cases of skin endometriosis have been described in the literature”
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    Premisecitation
    § Discussion

    In a review by Stojanovic et al, 210 cases of skin endometriosis located on surgical scars were found, of which 119 followed a C-section procedure.

    “in a review published by Stojanovic et al, they found 210 cases of skin endometriosis located on surgical scars, whereof 119 cases followed a C-section procedure (8).”
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    Premisecitation
    § Discussion

    Skin endometriosis usually affects women in their reproductive age (mean age 30-40 years).

    “Skin endometriosis usually affects women in their reproductive age (mean age 30-40 years)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18]

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    Premisecitation
    § Discussion

    Costa et al described the dermoscopy pattern of cutaneous endometriosis in the follicular phase as erythematous-violaceous polypoid projections with light brown spots and areas of active bleeding; in the luteal phase the dermoscopic feature was an erythematous-bluish aspect.

    “Moreover, Costa et al described the dermoscopy pattern of cutaneous endometriosis in the follicular phase as erythematous-violaceous polypoid projections with light brown spots and areas of active bleeding; further in the luteal phase the dermoscopic feature of the lesion was as an erythematous-bluish aspect (17).”
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    Premisecitation
    § Discussion

    Multiple factors such as the site of occurrence, histological subtype, depth of the lesion or patient phototype may influence the dermoscopic aspect of skin endometriosis.

    “Multiple factors such as the site of occurrence, histological subtype, depth of the lesion or patient phototype may influence the dermoscopic aspect of skin endometriosis (16).”
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    Premisecitation
    § Discussion

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

    “Kinkel et al reported the sensitivity and specificity of MRI in diagnosing endometriomas to be 90-92 and 91-98%, respectively (15).”
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    Premisecitation
    § Discussion

    A study by de Giorgi et al revealed dominant dermoscopic features in skin endometriosis such as homogeneous reddish pigmentation, containing small red globular structures, termed 'red atolls'.

    “A study published by de Giorgi et al revealed dominant dermoscopic features in skin endometriosis such as homogeneous reddish pigmentation, containing small red globular structures, which they termed 'red atolls' (7).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
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    Premisecitation
    § Discussion

    Tumor markers such as CA19-9 and CA125 may or may not be elevated; however histologic examination after excision of the lesion can confirm the diagnosis.

    “Tumor markers such as CA19-9 and CA125 may or may not be elevated; however histologic examination after excision of the lesion can confirm the diagnosis (14).”
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    Premisecitation
    § Discussion

    The clinical differential diagnoses of skin endometriosis include incisional hernia, lipoma, dermoid cyst, abscess, suture granuloma, keloid, melanoma, hematoma and others.

    “The clinical differential diagnoses of skin endometriosis are represented by incisional hernia, lipoma, dermoid cyst, abscess, suture granuloma, keloid, melanoma, hematoma and others (11,12).”
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    Premisecitation
    § Discussion

    Ultrasonography seems to be the first choice for evaluation of any abdominal lesion, but CT and MRI may exclude other possible diagnoses such as a lipoma, hernia or a tumor.

    “Ultrasonography seems to be the first choice for evaluation of any abdominal lesion, but CT and MRI may exclude other possible diagnoses such as a lipoma, hernia or a tumor (13).”
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    Premisecitation
    § Discussion

    The production of estrogen can be stimulated in endometrial lesions by aromatase activity.

    “The production of estrogen can be stimulated in endometrial lesions by aromatase activity (29).”
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    Premisecitation
    § Discussion

    After surgery, the average period to the onset of symptoms is between 3 months and 18 years.

    “After surgery the average period to the onset of symptoms is between 3 months to 18 years (19).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19]

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    Premisecitation
    § Discussion

    During a C-section procedure, endometrial tissue could be iatrogenically grafted into ectopic sites such as the skin, muscles or other layers of the abdominal wall, which is why the nodule appears frequently above the scar.

    “Another theory explains the possibility that during a C-section procedure endometrial tissue could be iatrogenically grafted into ectopic sites such as the skin, muscles or other layers of the abdominal wall, this being the reason why the nodule appears frequently above the scar.”
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    Premisecitation
    § Discussion

    One accepted theory suggests that primitive pluripotent mesenchymal cells that have undergone differentiation metaplasia are one of the causes of abdominal wall endometriosis.

    “Concerning the possible pathophysiological mechanisms involved, one accepted theory suggests that primitive pluripotent mesenchymal cells that have undergone differentiation metaplasia are one of the cause of abdominal wall endometriosis (30).”
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    Premisecitation
    § Discussion

    According to the literature, an increased Ki67 and CD10 positivity indicates that the stroma is decidualized.

    “According to the literature, an increased Ki67 and CD10 positivity indicates that the stroma is decidualized (24).”
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    Premisecitation
    § Discussion

    Some authors propose that retrograde menstruation could be a cause for the implantation of endometrial cells in the peritoneal area, while others advocate the theory of lymphatic or hematogenic dissemination, the role of genetics and other probable pathophysiological mechanisms.

    “In addition, some authors propose that retrograde menstruation could be a cause for the implantation of endometrial cells in the peritoneal area (31), while others advocate the theory of lymphatic or hematogenic dissemination (32), the role of genetics (33) and other probable pathophysiological mechanisms (34,35).”
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    Premisecitation
    § Discussion

    Studies have reported that CD10 is a useful marker for diagnosis as it is strongly expressed in endometrial stromal nodules.

    “Studies have reported that CD10 as a useful marker for diagnosis as it is strongly expressed in endometrial stromal nodules (23).”
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    Premisecitation
    § Discussion

    The symptoms associated with skin endometriosis are pain, tenderness or bleeding during the menstrual cycle, and their persistence ranges from 2 months to 2 years.

    “The symptoms associated with this disease are pain, tenderness or bleeding during menstrual cycle and their persistence ranges from 2 months to 2 years (18).”
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    Premisecitation
    § Discussion

    A retrospective study of 198 Caesarean scar-related endometriosis cases by Zhang et al found more than 70% of the endometrial cases in superficial regions of the abdominal wall; 5.7% were found in the adipose layer and 64.6% between the adipose layer and the fascia layer, and 83% were located in a corner of the Pfannenstiel incision scar.

    “A retrospective study of 198 Caesarean scar-related endometriosis cases by Zhang et al found more than 70% of the endometrial cases in superficial regions of the abdominal wall; 5.7% were found in the adipose layer and 64.6% between the adipose layer and the fascia layer, and 83% were located in a corner of the Pfannenstiel incision scar (38).”
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    Interpretationreasoning
    § Discussion

    In our patient, the cause for this ectopic tissue may have been the iatrogenic transportation of endometrial cells during the C-section incision.

    “In our patient, the cause for this ectopic tissue may have been the iatrogenic transportation of endometrial cells during the C-section incision.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation
    § Discussion

    Ding and Zhu conducted another retrospective study with similar results; 77.1% of the cases were located in the corners of the scars.

    “Ding and Zhu conducted another retrospective study with similar results; 77.1% of the cases were located in the corners of the scars (39).”
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    Premisecitation
    § Discussion

    The most frequently used abdominal skin incisions are Pfannenstiel incision and vertical midline; therefore C-section seems to be one of the most popular surgical procedures utilized on the female population.

    “The most frequently used abdominal skin incisions are Pfannenstiel incision and vertical midline; therefore C-section seems to be one of the most popular surgical procedures utilized on the female population (38,39).”
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    Premisecitation
    § Discussion

    The recurrence rate of skin endometriosis is generally low, but other publications have described recurrence in 6-11% of patients.

    “The recurrence rate is generally low, but other publications have described recurrence in 6-11% of patients (40,41).”
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    Interpretationnone given
    § Discussion

    Generally, surgical excision is the first-line treatment as it is the best way to establish a clear diagnosis and to ensure a low rate of recurrence.

    “Generally, surgical excision is the first-line treatment as it is the best way to establish a clear diagnosis and to ensure a low rate of recurrence.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data
    § Case report

    Written informed consent was provided by the patient for diagnostic and therapeutic procedures and for publication.

    “Written informed consent was provided and the patient agreed to undergo diagnostic and therapeutic procedures included in the study protocol that was conducted in accordance with the Declaration of Helsinki with approval of the Ethics Committee of the Colentina Clinical Hospital (approval no.25/27.11.2017).”
    • Also stated in: § Additional information · plain
      “Written informed consent of the patient was obtained for publication of the information.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationnone given
    § Discussion

    Skin endometriosis is a rare and benign condition, with an unknown mechanism and a very low rate of malignancy.

    “In conclusion, skin endometriosis is a rare and benign condition, with an unknown mechanism and a very low rate of malignancy.”
    Quote in the paperNot a substantial claim

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

    Premisecitation
    § Discussion

    The goal of postoperative hormonal therapy is to prevent recurrence, but its use is still under debate as the overall result has been poor.

    “The goal of postoperative hormonal therapy is to prevent recurrence, but its use is still under debate as the overall result has been poor (43).”
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    Premisecitation
    § Discussion

    Preoperative therapy is effective in ameliorating symptoms such as pain and minimizing the lesion size.

    “Preoperative therapy is effective in ameliorating symptoms such as pain and minimizing the lesion size.”
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    Premisecitation
    § Discussion

    One of the most common types of cancer associated with endometriosis is clear-cell carcinoma, with a survival rate of 80%.

    “one of the most common types is clear-cell carcinoma with a survival rate of 80% (39,42).”
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    Premisecitation
    § Discussion

    The malignancy rate of endometriosis is extremely low, with less than 1% of endometriosis cases reported in association with cancer.

    “The malignancy rate is also extremely low with less than 1% of endometriosis cases reported in association with cancer”
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    Interpretationnone given
    § Discussion

    The first-line treatment of skin endometriosis is surgical excision and the gold standard for its diagnosis is histopathologic and, if necessary, immunohistochemical examination.

    “The first-line treatment of skin endometriosis is surgical excision and the gold standard for its diagnosis is histopathologic and, if necessary, immunohistochemical examination.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data
    § Case report

    The study protocol was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the Colentina Clinical Hospital (approval no.25/27.11.2017).

    “Written informed consent was provided and the patient agreed to undergo diagnostic and therapeutic procedures included in the study protocol that was conducted in accordance with the Declaration of Helsinki with approval of the Ethics Committee of the Colentina Clinical Hospital (approval no.25/27.11.2017).”
    • Also stated in: § Additional information · plain
      “Ethics approval was obtained from the Ethics Committee of the Colentina Clinical Hospital (approval no.25/27.11.2017).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationnone given
    § Discussion

    The clinical appearance of skin endometriosis is very unspecific, which may hinder the dermatologist's diagnosis, delaying the right management of the lesion.

    “Its clinical appearance is very unspecific which may hinder the dermatologist's diagnosis, delaying the right management of the lesion.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning
    § Discussion

    The associated incidence of skin endometriosis (found on or in close proximity to a scar associated with C-section) may increase in the future.

    “the associated incidence in skin endometriosis (found on or in close proximity to a scar associated with this procedure) may increase in the future.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The rate of C-section is increasing in the female population.
47 of 47

  • The paper relies on this without support.

    The rate of C-section is increasing in the female population.

    “The rate of C-section is increasing in the female population”
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  • Total surgical resection is considered the gold standard for both diagnosis and treatment of scar endometrial lesions.

    “Total surgical resection is considered to be the gold standard for both diagnosis and treatment of scar endometrial lesions. 8”

    From Caesarean Scar Endometriosis May Require Abdominoplasty (2021) · cites this paper as [8]

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Stojanovic M, Brasanac D and Stojicic M: Cutaneous inguinal scar endosalpingiosis and endometriosis: Case report with review of literature. Am J Dermatopathol 35: 254-260, 2013.

Cited by

Sorted by citations

Related

Authors
Matei, A.-M., Draghici‑Ionescu, A.-M., Cioplea, M., Zurac, S., Boda, D., Serban, I., Caruntu, C., Ilie, M., & Gyula, L.
Affiliations
  • Spitalul Clinic Colentina (RO)
  • Department of Dermatology, Colentina Clinical Hospital, 020125 Bucharest, Romania
  • Carol Davila University of Medicine and Pharmacy (RO)
  • Department of Dermatology, ‘Prof. N.C. Paulescu’ National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
  • Department of Physiology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
  • Universitatea de Medicină, Farmacie, Științe și Tehnologie „George Emil Palade” din Târgu Mureș (RO)
ORCID
Venue
Experimental and Therapeutic Medicine
Publisher
Spandidos Publications
Published
2021-03-23
Volume
21
Issue
5
Pages
532-532
ISSN
  • 1792-0981 (ISSN-L)
  • 1792-1015
DOI
10.3892/etm.2021.9964
PMC
PMC8014966
OpenAlex
W3137129305
Cited by
16
References
38
Citations by year
2026: 1 · 2025: 4 · 2024: 3 · 2023: 2 · 2022: 2 · 2021: 4
FWCI
2.37
Type
journal article
Language
en
Open access
Locations
  • Experimental and Therapeutic Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Unitatea Executiva pentru Finantarea Invatamantului Superior, a Cercetarii, Dezvoltarii si Inovarii (PN-III-P1-1.2-PCCDI-2017-0341, PN- III -P1-1, PN-III-P1-1.2-PCCDI)
  • Colegiul Consultativ pentru Cercetare-Dezvoltare şi Inovare
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Medicine › Surgery › Teratomas and Epidermoid Cysts
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
Keywords
subcutaneous nodules, postoperative scarring, obstetric surgery, ovarian endometriotic cysts, delayed diagnosis, extrapelvic endometriosis

About these checks

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.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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