Scar Endometriosis: Cytological Diagnosis

Area of Science:

• Gynecologic Pathology
• Surgical Pathology
• Immunocytology

Background:

• Incisional endometriosis is a rare condition where endometriosis tissue implants within a surgical scar.
• It typically occurs after obstetric or gynecologic surgeries, with reported incidence rates between 0.03% and 1.08%.
• Diagnosis can be challenging as symptoms may mimic other abdominal wall pathologies.

Observation:

• A 28-year-old female presented with an anterior abdominal wall mass.
• Fine needle aspiration (FNA) cytology revealed epithelial cells and stromal fragments.
• Immunohistochemistry for CK 7 and CD 10 confirmed glandular and stromal components, respectively.

Findings:

• The immunocytological findings, including immunohistochemistry, led to a cytodiagnosis of scar endometriosis.
• This case demonstrates the utility of immunocytology in diagnosing rare conditions like incisional endometriosis.
• The positive staining for CK 7 in glandular cells and CD 10 in stromal cells supported the diagnosis.

Implications:

• Accurate and timely diagnosis of incisional endometriosis is crucial for appropriate patient management.
• Considering incisional endometriosis in the differential diagnosis of anterior abdominal wall masses in women with a history of gynecologic surgery is essential.
• This diagnostic approach can help avoid unnecessary surgical interventions and guide treatment strategies.