Rectus abdominis endometriosis. A descriptive analysis of 10 cases concerning this rare occurrence

Hussien A Mostafa, Jamel H Saad, Jamel Saad, Zafer Nadeem, Fawaz Abdullah Alharbi, Fawaz Alharbi
Saudi medical journal · 2013 · vol. 34(10) , pp. 1035–1042 · doi:10.15537/1658-3175.5836 · PMID:24145938 · W1567076849
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This descriptive analysis reviewed 10 cases of rectus abdominis endometriosis, detailing clinical and imaging findings, histopathology, and successful surgical excision, with no reported recurrence.

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This descriptive study reported 10 surgically proven cases of rectus abdominis endometrioma over a 5-year period (2007–2012) in women from Egypt and Saudi Arabia, detailing clinical presentation, imaging (ultrasound in all, with CT/MRI in some), cytohistological findings, and wide surgical excision. Abdominal pain was present in all patients, a palpable mass in 3, and most lesions were associated with prior cesarean section history; importantly, in one patient with two lesions, MRI detected a lesion missed by ultrasound. Fine needle aspiration was performed in two cases and histopathology confirmed the diagnosis in every instance, with no complications or recurrence reported during 6–24 months of follow-up. This paper is centrally about endometriosis — specifically rectus abdominis (abdominal wall) endometrioma and its imaging, pathology, and surgical management.

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Abstract

OBJECTIVE: To report 10 cases of rectus abdominis endometrioma, emphasizing the clinical presentations, imaging investigations, cytohistological findings, and surgical treatment employed. METHODS: This is a descriptive analysis of 10 surgically-proven cases of rectus abdominis muscle endometriosis, seen over a 5-year period from 2007 to 2012 at Sohag University Hospital, Sohag, Egypt and Najran Armed Forces Hospital, Najran, Saudi Arabia. All patients had undergone ultrasonography. Computerized tomography (CT) and magnetic resonance imaging (MRI) were performed in some cases. Surgical excision was the way of treatment in all patients. RESULTS: This study was carried out in 10 women with a mean age of 33.9 years. Nine cases had previous history of cesarean section (CS) while one patient had laparoscopy converted to laparotomy for ovarian cyst. All patients were presented with abdominal pain but only 3 had a palpable mass. Ten lesions within the rectus abdominis muscle were detected with automated ultrasound and MRI depicted one lesion, which was missed by ultrasound in a patient who had 2 concomitant lesions. Preoperative fine needle aspiration (FNA) was carried out in 2 patients. Wide surgical excision was performed in all cases. Histopathology was confirmatory in each instance. No complications or recurrence were recorded on follow-up (6-24 months; mean 13.2 months). CONCLUSION: This disease is not as rare as previously thought, and should be included in the differential diagnosis of abdominal wall masses in reproductive-age females.
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Abstract OBJECTIVE: To report 10 cases of rectus abdominis endometrioma, emphasizing the clinical presentations, imaging investigations, cytohistological findings, and surgical treatment employed. METHODS: This is a descriptive analysis of 10 surgically-proven cases of rectus abdominis muscle endometriosis, seen over a 5-year period from 2007 to 2012 at Sohag University Hospital, Sohag, Egypt and Najran Armed Forces Hospital, Najran, Saudia Arabia. All patients had undergone ultrasonography. Computerized tomography (CT) and magnetic resonance imaging (MRI) were performed in some cases. Surgical excision was the way of treatment in all patients. RESULTS: This study was carried out in 10 women with a mean age of 33.9 years. Nine cases had previous history of cesarean section (CS) while one patient had laparoscopy converted to laparotomy for ovarian cyst. All patients were presented with abdominal pain but only 3 had a palpable mass. Ten lesions within the rectus abdominis muscle were detected with automated ultrasound and MRI depicted one lesion, which was missed by ultrasound in a patient who had 2 concomitant lesions. Preoperative fine needle aspiration (FNA) was carried out in 2 patients. Wide surgical excision was performed in all cases. Histopathology was confirmatory in each instance. No complications or recurrence were recorded on follow-up (6-24 months; mean 13.2 months). CONCLUSION: This disease is not as rare as previously thought, and should be included in the differential diagnosis of abdominal wall masses in reproductive-age females. Article Type Research Article First Page 1035 Last Page 1042 Recommended Citation Mostafa, Hussien A.; Saad, Jamel H.; Nadeem, Zafer; and Alharbi, Fawaz (2013) "Rectus abdominis endometriosis. A descriptive analysis of 10 cases concerning this rare occurrence," Saudi Medical Journal: Vol. 34: Iss. 10, Article 9. DOI: https://doi.org/10.15537/1658-3175.5836

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Condition tags

mesh:D004715endometriosisendometrioma

MeSH descriptors

Endometriosis Rectus Abdominis Adult Biopsy, Needle Endometriosis Endometriosis Endometriosis Female Humans Magnetic Resonance Imaging Middle Aged Rectus Abdominis Rectus Abdominis Ultrasonography

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