Parietal Endometriosis: A Challenge for the General Surgeon

Area of Science:

• Gynecology
• Surgical Pathology

Background:

• Parietal endometriosis (PE) is a rare condition typically affecting women of reproductive age.
• It often arises after surgical or gynecological procedures.
• Symptoms include cyclical pain and a palpable mass, but diagnosis can be challenging due to its similarity to other conditions.

Purpose of the Study:

• To review cases of parietal endometriosis to highlight diagnostic challenges and surgical outcomes.
• To emphasize the importance of accurate preoperative diagnosis for effective management.

Main Methods:

• A retrospective analysis of 10 female patients diagnosed with parietal endometriosis between 2007 and 2017.
• Review of clinical presentation, diagnostic methods, surgical procedures, and outcomes.

Main Results:

• The average patient age was 35.8 years, with pain and a palpable mass being the predominant symptoms.
• Five patients were correctly diagnosed preoperatively, while five were misdiagnosed (4 as tumors, 1 as stitch granuloma).
• Eight patients had a history of gynecological procedures; mass sizes ranged from 1 to 14 cm, with five requiring mesh for parietal reconstruction.

Conclusions:

• Parietal endometriosis is a rare surgical entity requiring careful diagnostic consideration.
• Thorough patient history, physical examination, and appropriate imaging are essential for accurate diagnosis.
• Correct diagnosis guides the selection of the appropriate surgical approach.