Endometriosis of the Abdominal Wall: Case Review and Literature Insights

Background: Abdominal wall endometriosis (AWE) is an uncommon extrapelvic manifestation of endometriosis, most frequently occurring in surgical scars after cesarean section. It usually presents as a painful subcutaneous nodule with cyclic exacerbation. Case presentation: We report the case of a 34-year-old woman presenting with a painful nodule at a cesarean section scar. Clinical examination revealed a firm, tender mass. Ultrasound showed a heterogeneous hypoechoic lesion with peripheral vascularity. CT imaging confirmed a heterogeneous soft-tissue mass within the anterior abdominal wall at the cesarean scar, with mild peripheral enhancement. The patient underwent wide local excision with mesh repair. Histopathology confirmed abdominal wall endometriosis. Conclusion: AWE should be suspected in women with painful scar-related nodules. Imaging defines lesion extent, histology provides confirmation, and complete excision remains the treatment of choice.