Cesarean Scar Endometriosis Mimicking Suture Granuloma: A Rare Case Report

Introduction: Scar endometriosis is an uncommon form of extra-pelvic endometriosis that occurs when endometrial tissue develops within or near a surgical scar, most often following cesarean section. Due to its nonspecific presentation, it is frequently misdiagnosed. Case Report: A 30-year-old woman presented with pain and swelling at the site of a previous cesarean section scar. The pain showed cyclical variation with menstruation. Clinical examination revealed a firm, tender, non-mobile mass. Ultrasonography suggested a hypoechoic lesion with internal vascularity, initially raising suspicion of a benign condition such as suture granuloma. The mass was surgically excised and examined histologically, which confirmed the presence of endometrial glands and stroma consistent with scar endometriosis. Discussion: The patient underwent complete surgical excision of the lesion along with surrounding tissue. Recovery was uneventful, and no recurrence was noted on follow-up. Surgical removal remains the definitive treatment, as medical therapy offers only temporary symptom relief. Conclusion: Scar endometriosis should be considered in women presenting with a a surgical scar, especially with cyclical symptoms. Early diagnosis and complete excision are essential for effective management. Increased awareness and careful surgical techniques may help reduce its occurrence.