[Endometriosis in a laparotomic scar after cesarean section: report of two cases]

Extrapelvic endometriosis in an abdominal wall surgical scar is a rare entity that is difficult to diagnose. However, it should be suspected in any woman of childbearing age complaining of a cyclic painful nodule in a scar from a previous obstetric or gynecologic procedure, after excluding other conditions such as incisional hernia, late abscess, or suture granuloma. Fine-needle aspiration biopsy provides an accurate preoperative diagnosis. Imaging studies such as ultrasound, computed tomography, or magnetic resonance imaging are non-specific, but may be helpful in identifying the exact anatomical location of the lesion and in excluding other surgical conditions. We present two cases of endometriosis in an abdominal wall scar that developed after cesarean section performed 7 years previously. In both patients, preoperative diagnosis, based on clinical suspicion in the first patient and aspiration cytology in the second, was correct. Wide local excision was curative in both patients.