Spontaneous abdominal wall endometriosis: A case report

Area of Science:

• Gynecology
• Surgical Pathology

Background:

• Abdominal wall endometriosis (AWE) is a rare gynecological condition, typically associated with prior abdominal surgery or pelvic endometriosis.
• Early and accurate diagnosis of AWE is crucial to prevent diagnostic delays and ensure appropriate management.

Observation:

• A 48-year-old woman presented with cyclical abdominal pain and distension, with a palpable suprapubic mass correlating with menstruation.
• Ultrasound revealed a subcutaneous hypoechoic lesion in the right suprapubic region, alongside multiple uterine fibroids.
• Intraoperative findings showed a 6x5 cm AWE mass adherent to the rectus sheath, without connection to the peritoneal cavity, and no evidence of pelvic endometriosis.

Findings:

• Histopathological examination confirmed the abdominal wall mass as endometriosis.
• The patient had no history of abdominal surgery or known pelvic endometriosis, making this a unique presentation of AWE.

Implications:

• This case underscores the importance of considering AWE in the differential diagnosis of abdominal wall masses, particularly when cyclical symptoms are present, even without a surgical history.
• Increased clinical suspicion for AWE is warranted in patients presenting with abdominal masses related to the menstrual cycle.