A scar that cycles: unmasking episiotomy site endometriosis: a case report

Niteen Ghorpade, Tushar L. Rahane, Anuvi Sinha
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2025 · vol. 14(10) , pp. 3567–3569 · doi:10.18203/2320-1770.ijrcog20253111 · W4414556556
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This case report describes a 31-year-old woman with cyclical pain and a mass at her episiotomy scar, confirming episiotomy site endometriosis, with surgical excision being the definitive treatment.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

This case report describes a 31-year-old woman who developed cyclical pain and a hard nodular mass (3×4 cm) at an episiotomy scar site 6 years after vaginal delivery. The authors performed thorough examination and imaging, followed by complete excision of the mass, and histopathology confirmed scar-site (cutaneous/extrapelvic) endometriosis. The main limitation is that, as a single-case report, it does not establish generalizable effectiveness of any approach beyond the described diagnostic workup and surgical management. This paper is centrally about endometriosis — it specifically presents episiotomy scar endometriosis presenting with cyclical pain and a nodular mass.

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Abstract

Endometriosis is a condition characterised by occurrence of endometrial cells outside the uterine cavity and when it appears at the previous scar site like episiotomy scar, caesarean scar or laparoscopic port incision scar sites, it is called extrapelvic or cutaneous endometriosis. Here we present a case of 31-year-old lady who had vaginal delivery with episiotomy scar 6 years ago. She presented at our center with cyclical pain at the episiotomy scar site and a hard nodular mass of 3×4 cm was found at the episiotomy site. She underwent complete excision of mass after thorough examination and imaging. The hsitopathology report confirmed the diagnosis. Hence, we knew that the definitive treatment of episiotomy scar site endometriosis is surgical and medical management has no role.
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A scar that cycles: unmasking episiotomy site endometriosis: a case report DOI: https://doi.org/10.18203/2320-1770.ijrcog20253111Keywords: Episiotomy, Scar site endometriosis, Cutaneous endometriosis, Extra pelvic endometriosis, Vaginal delivery, Caesarean sectionAbstract Endometriosis is a condition characterised by occurrence of endometrial cells outside the uterine cavity and when it appears at the previous scar site like episiotomy scar, caesarean scar or laparoscopic port incision scar sites, it is called extrapelvic or cutaneous endometriosis. Here we present a case of 31-year-old lady who had vaginal delivery with episiotomy scar 6 years ago. She presented at our center with cyclical pain at the episiotomy scar site and a hard nodular mass of 3×4 cm was found at the episiotomy site. She underwent complete excision of mass after thorough examination and imaging. The hsitopathology report confirmed the diagnosis. Hence, we knew that the definitive treatment of episiotomy scar site endometriosis is surgical and medical management has no role. Metrics References Sinha A, Rahane TL, Ghorpade N. When endometriosis returns: managing vault involvement after hysterectomy: a case report. Int J Reprod Contracept Obstet Gynecol 2025;14(7):2391-4. DOI: https://doi.org/10.18203/2320-1770.ijrcog20251998 Hakami R, AlMansour S, Aloraini HM, Alturki NI, Alswayyed M, AlHarbi RA, et al. Isolated Perianal Endometrioma: A Case Report and Literature Review. Am J Case Rep. 2022;23:e934745. DOI: https://doi.org/10.12659/AJCR.934745 McComb K, Barghash M, Eltayef S. Perianal Endometriosis: An Uncommon Site for a Common Problem. Cureus. 2023;15(9):e44840. DOI: https://doi.org/10.7759/cureus.44840 Hirata T, Koga K, Osuga Y. Extra-pelvic endometriosis: A review. Reprod Med Biol. 2020;19(4):323-33. DOI: https://doi.org/10.1002/rmb2.12340 Durairaj A, Sivamani H, Panneerselvam M. Surgical Scar Endometriosis: An Emerging Enigma. Cureus. 2023;15(2):e35089. DOI: https://doi.org/10.7759/cureus.35089 Gonzalez RH, Singh MS, Hamza SA. Cutaneous Endometriosis: A Case Report and Review of the Literature. Am J Case Rep. 2021;22:e932493. DOI: https://doi.org/10.12659/AJCR.932493

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endometriosis

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