Scar endometriosis in a patient with bladder exstrophy

Area of Science:

• Gynecology
• Surgical Pathology

Background:

• Endometriosis is defined as the presence of endometrial-like tissue outside the uterus.
• Scar endometriosis is a known extrapelvic manifestation, typically following surgical procedures.
• Endometriosis following bladder exstrophy surgery has not been previously documented.

Observation:

• A 26-year-old woman with a history of bladder exstrophy presented with a painful induration at a left lower abdominal wall surgical scar.
• Symptoms recurred after initial resolution, with imaging revealing a heterogeneous mass.
• Magnetic resonance imaging demonstrated a 16 mm mass with characteristic signal intensities.

Findings:

• Histopathological examination of the excised lesion confirmed endometriosis.
• The diagnosis was established in a patient with a history of bladder exstrophy and prior abdominal surgery.
• The lesion was located within the abdominal wall scar.

Implications:

• This case expands the known spectrum of scar endometriosis locations.
• It highlights the importance of considering endometriosis in patients with a history of bladder exstrophy presenting with abdominal wall masses.
• Early diagnosis and surgical excision are effective management strategies.