A Case Report of an Abdominal Wall Endometrioma

Abdominal wall endometrioma (AWE) is one of the rarest forms of the endometriosis, and usually found in the young patients, average age is 35years. The most common triad of the symptoms is, abdominal mass at or near the scar, cyclical pain and history of previous caesarean or any other gynecological surgery. Exact pathogenesis is unknown as average time of its presentation in the patients is highly variable from 3 months till 2 decades. It can be suspected on ultrasonography and CT scan and MRI are the modalities used to assess and stage the lesion prior to the surgery. Histopathological diagnosis is confirmatory. We are reporting 30 years old, Para 2, with history of first caesarean section 6 years ago followed by the normal delivery. She presented with the history of cyclical abdominal pain with the feeling of abdominal lump from last 3 months. On examination a slightly tender 5*4 cm extra abdominal mass was palpable above the right half of the previous transverse scar of the caesarean. After evaluation endometriosis was suspected and the patient opted for the surgical resection of the mass. The mass was removed in collaboration with the surgeons and the histopathology confirmed the diagnosis of the AWE. Conclusion: AWE is a dynamic yet incompletely known entity as a result of increasing number of the caesarean and gynecological procedures. It should be kept in the differential diagnosis of the patients coming with the cyclical abdominal pain and abdominal lump with the history of previous uterine surgery. Ultrasound and MRI are the main aiding modalities but the confirmation of the diagnosis is made only after histopathology. The surgical removal of the mass with negative margins represents the current best treatment. Key words: Abdominal wall, endometriosis, magnetic resonance imaging, ultrasonography.