Abdominal wall endometriosis after cesarean section

Tomohito Tanaka, Yoshito Terai, Masahide Ohmichi
In: The Journal of the Japanese Society of Clinical Cytology · 2010 · vol. 49(5) , pp. 364–368 · doi:10.5795/jjscc.49.364 · W2009699447
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⚙ AI-generated summary by claude@2026-06, 2026-06-12 ⓘ

This case report describes a 26-year-old woman diagnosed with abdominal wall endometriosis after cesarean section, where fine-needle aspiration cytology aided diagnosis and wide local excision provided effective treatment.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text ⓘ

This paper reports a single case of abdominal wall endometriosis occurring in a 26-year-old woman with no prior endometriosis history, presenting as a firm 15×3×3 cm mass near a cesarean section scar along the rectus abdominis muscle. Despite 6 months of treatment with a gonadotropin-releasing hormone (GnRH) analog, her symptoms persisted and increased and the lesion progressively enlarged, but fine-needle aspiration cytology showed epithelial and stromal cellular sheets with a hemorrhagic background consistent with endometrium and excluding carcinoma. The patient underwent wide local excision with negative margins and had continued recovery at 18 months. The paper is limited by its single-case design. This paper is centrally about endometriosis — specifically abdominal wall endometriosis arising after a cesarean section.

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Abstract

Background : Abdominal wall endometriosis is rare and difficult to diagnose. Overall abdominal wall endometriosis incidence has been reported 0.03-1.0% of women with cesarean section scar.Case : We report the case of a 26-year-old woman with no endometriosis history. The 15×3×3 cm tumor was firm and located at a right angle from the incision of a cesarean section conducted 2 years earlier along the rectus abdominis muscle to the umbilicus level. Regardless of treatment with a gonadotropin-releasing hormone (GnRH) analog for 6 months, the woman showed ongoing, increasing symptoms fluctuating with her menses, and the lesion also gradually grew. Fine-needle aspiration cytology (FNAC) showed cellular sheets of epithelial and stromal cells against a hemorrhagic background that confirmed the presence of endometrium and excluded carcinoma. The woman was clinically diagnosed with abdominal wall endometriosis, eventually undergoing wide local excision of the lesion with negative margins. Follow-up at 18 months showed continued recovery.Conclusion : We found FNAC to be useful in preoperative diagnosis, and surgical management provides the best option for both a definitive diagnosis and effective treatment of large abdominal wall endometriosis.
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Abstract

Background : Abdominal wall endometriosis is rare and difficult to diagnose. Overall abdominal wall endometriosis incidence has been reported 0.03-1.0% of women with cesarean section scar. Case : We report the case of a 26-year-old woman with no endometriosis history. The 15×3×3 cm tumor was firm and located at a right angle from the incision of a cesarean section conducted 2 years earlier along the rectus abdominis muscle to the umbilicus level. Regardless of treatment with a gonadotropin-releasing hormone (GnRH) analog for 6 months, the woman showed ongoing, increasing symptoms fluctuating with her menses, and the lesion also gradually grew. Fine-needle aspiration cytology (FNAC) showed cellular sheets of epithelial and stromal cells against a hemorrhagic background that confirmed the presence of endometrium and excluded carcinoma. The woman was clinically diagnosed with abdominal wall endometriosis, eventually undergoing wide local excision of the lesion with negative margins. Follow-up at 18 months showed continued recovery.

Conclusion

We found FNAC to be useful in preoperative diagnosis, and surgical management provides the best option for both a definitive diagnosis and effective treatment of large abdominal wall endometriosis. Case : We report the case of a 26-year-old woman with no endometriosis history. The 15×3×3 cm tumor was firm and located at a right angle from the incision of a cesarean section conducted 2 years earlier along the rectus abdominis muscle to the umbilicus level. Regardless of treatment with a gonadotropin-releasing hormone (GnRH) analog for 6 months, the woman showed ongoing, increasing symptoms fluctuating with her menses, and the lesion also gradually grew. Fine-needle aspiration cytology (FNAC) showed cellular sheets of epithelial and stromal cells against a hemorrhagic background that confirmed the presence of endometrium and excluded carcinoma. The woman was clinically diagnosed with abdominal wall endometriosis, eventually undergoing wide local excision of the lesion with negative margins. Follow-up at 18 months showed continued recovery.

Conclusion

We found FNAC to be useful in preoperative diagnosis, and surgical management provides the best option for both a definitive diagnosis and effective treatment of large abdominal wall endometriosis. © 2010 The Japanese Society of Clinical Cytology Favorites & Alerts Recently viewed articles

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