[Endometriosis in an episiotomy scar]

Area of Science:

• Gynecology
• Obstetrics
• Surgical Pathology

Background:

• Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus.
• Episiotomy scars are potential sites for ectopic endometrial tissue implantation.
• Perineal endometriosis is a rare manifestation, often presenting as a palpable mass.

Observation:

• A 25-year-old woman presented with symptoms in an episiotomy scar six years after her second delivery.
• The patient underwent surgical excision for the suspected endometrioma.
• Recurrence of the endometrioma was noted shortly after the initial surgical intervention.

Findings:

• Histopathological examination confirmed endometriosis at the episiotomy scar site.
• The clinical presentation suggested decidual autologous transplantation as a potential cause for recurrence.
• Manual uterine exploration during a prior procedure may have facilitated this transplantation.

Implications:

• This case highlights the possibility of perineal endometriosis developing at episiotomy sites.
• Recurrence after surgical management underscores the importance of considering iatrogenic factors like transplantation.
• Further research into prevention and management strategies for iatrogenic endometriosis is warranted.