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Symptomatic cesarean scar diverticulum: a case report.

Robert J Fischer1

  • 1Department of Obstetrics and Gynecology, 1st Fighter Wing Hospital/SGOBO, 45 Pine Street, Langley Air Force Base, VA 23665-2025, USA. robert.fischer@langley.af.mil

The Journal of Reproductive Medicine
|October 17, 2006
PubMed
Summary
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A rare case of intermediate trophoblast lesion was found in a cesarean scar diverticulum, presenting as irregular vaginal bleeding. This finding highlights a new potential cause for gynecological bleeding in women with prior cesarean deliveries.

Area of Science:

  • Gynecologic pathology
  • Reproductive endocrinology
  • Obstetrics and Gynecology

Background:

  • Extrauterine intermediate trophoblast lesions are linked to ectopic pregnancy implantation sites.
  • Cesarean scar defects can cause persistent vaginal bleeding and are detectable via pelvic ultrasound.

Observation:

  • A 35-year-old woman presented with irregular vaginal bleeding and an anterior extrauterine cystic mass on pelvic ultrasound, suspected to be a cesarean scar defect.
  • Histological examination revealed an endometrial diverticulum lined by chorionic-type intermediate trophoblast.

Findings:

  • This case represents the first documented instance of an intermediate trophoblast lesion within a cesarean scar diverticulum.
  • The lesion was characterized by chorionic-type intermediate trophoblast, consistent with placental site nodules.

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Implications:

  • This discovery expands the differential diagnosis for abnormal uterine bleeding in women with a history of cesarean delivery.
  • Recognizing this entity is crucial for accurate diagnosis and management of gynecological bleeding disorders.