Cesarean scar endometrioma: Case series

Area of Science:

• Gynecology
• Surgical Pathology

Background:

• Endometrioma, a condition where endometrial tissue grows outside the uterus, can occur in surgical scars.
• Cesarean scars are a potential site for endometrioma development, leading to localized pain and masses.

Purpose of the Study:

• To evaluate endometrioma specifically located at cesarean section scars.
• To discuss diagnostic approaches and treatment strategies for abdominal wall endometrioma.

Main Methods:

• Retrospective review of medical data from 6 patients with abdominal wall endometrioma.
• Literature review to supplement case series findings.
• Diagnostic imaging including Doppler ultrasonography (US).

Main Results:

• All 6 patients presented with painful masses at abdominal scars, with a history of cesarean section.
• Doppler US identified hypoechoic masses with a mean diameter of 30 mm.
• Initial diagnoses included endometrioma (4 patients) and incisional hernia (2 patients).
• Surgical excision was performed on 5 patients; one received hormone suppression therapy.

Conclusions:

• Differential diagnosis for abdominal wall masses should include endometrioma, tumors, and incisional hernias.
• Advanced imaging modalities such as Doppler US, CT, and MRI are crucial for diagnosis.
• Histopathological examination is definitive for diagnosis.
• Complete surgical excision is the recommended treatment, with precautions against auto-inoculation to prevent recurrence.