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Cesarean scar endometriosis. A report of two cases
1Department of Obstetrics and Gynecology, Keesler United States Air Force Medical Center, Keesler Air Force Base, 301 Fisher Street, Room 1A-132, MS 39534, USA.
Background:
Extrapelvic endometriosis is a fairly rare phenomenon. The majority of extrapelvic endometriosis involves scar tissue following obstetric/gynecologic procedures. Cesarean section scar endometriosis may be more common than reflected in the literature and has a distinct presentation and treatment.
Cases:
Two patients with histories of cesarean sections presented with a painful, enlarging mass involving the cesarean section scar. The pain was cyclic and strongest just prior to menstruation. Both patients were treated with surgical excision, and both specimens had endometriosis confirmed by histopathology.
Conclusion:
Endometriosis involving a cesarean section scar may be more common than thought. Patients typically present with a history of cesarean section or other obstetric/gynecologic surgery and are found to have a mass involving the scar, with symptoms intensifying prior to each menstrual cycle. Surgical excision is the treatment of choice, providing both diagnostic and therapeutic intervention.