{"paper_id":"98606d77-c558-4912-984a-f57aeaaf57d7","body_text":"Abstract\nEndometriosis is a common disorder in females of reproductive age. Surgical scar endometrioma after cesarean section develops in 1–2 % of patients, and usually presents as a tender and painful abdominal wall mass. The diagnosis is suggested by pre or perimenstrual pelvic pain and is often established only by histology. In this retrospective observational cohort study, we reviewed the medical records of five patients with a histopathological diagnosis of scar endometriosis. A scar mass was found on a previous Pfannenstiel incision in four patients and in a median cesarean section in one patient. The mean age at diagnosis (38.6 years, median 38) was older than reported elsewhere. A histological examination of the surgical specimen confirmed the diagnosis of endometriosis in all cases. During the follow-up period (mean 34.6 months), local recurrence (n = 1) and pelvic recurrence (n = 1) were treated surgically. Surgery is the treatment of choice for surgical scar endometriosis. Excision with histologically proven free surgical margins of 1 cm is mandatory to prevent recurrence. As scar endometriosis may be associated with pelvic localization, explorative abdominal laparoscopy may be indicated to exclude the intraperitoneal spread of the disease in symptomatic patients.\nReferences\nMoen MH, Muus KM. Endometriosis in pregnant and non-pregnant women at tubal sterilization. Hum Reprod. 1991;6:699–702.\nLu PY, Ory SJ. Endometriosis: current management. Mayo Clin Proc. 1995;70:453–63.\nBrenner C, Wohlgemuth S. Scar endometriosis. Surg Gynecol Obstet. 1990;170(6):538–40.\nRokitansky K. Über Uterusdrüsen-Neubildung. Z Gesellschaft Aerzte (Wien). 1860;16:577–81.\nSeydel AS, Sickel JZ, Warner ED, Sax HC. Extrapelvic endometriosis: diagnosis and treatment. Am J Surg. 1996;171:239–41.\nWilliams TJ. Pratt JH. Endometriosis in 1000 consecutive celiotomies: incidence and management. 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Am J Surg. 2003;185(6):596–8.\nConflict of interest\nNone.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nMistrangelo, M., Gilbo, N., Cassoni, P. et al. Surgical scar endometriosis. Surg Today 44, 767–772 (2014). https://doi.org/10.1007/s00595-012-0459-3\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00595-012-0459-3","source_license":"CC0","license_restricted":false}