Case analysis of abdominal wall endometriomas within 10 years

Objective To study the incidence and describ e features of abdominal wall endometrioma(AWE). Methods A retrospective study was conducted toward 26 patients who were pathologically dia gnosed with AWE from January 1994 through December 2004 . The patients' files w ere reviewed concerning presentation , diagnostic test , diagnosis and treatment .Pelvic endometriosis were also looked for and recorded. Results The incidence rate of AWE was 1.49 %(26/1 744)in patients with endometrio sis treated in our hospital during the 10-year period. Around 0.13 %(9/6 863 ) of the patients were performed cesarean sections in the same period. Their mean age was 31 years age (ranged 23～45 years).All patients had undergone at least 1 cesarean delivery before admission.No patient had a prior diagnosis of endome triosis even though seven patients had dysmenorrhea.Symptoms occurred from 4 mon ths to 10 years after their previous cesarean sections with an average of 4.1 y ear old .All the patients painful scar-related mass.The most common presentatio n was a cyclic painful abdominal mass (n=20). Sonography disclose d all subcutaneous nodules ranged 5～60 mm (average 36.4 mm). The preoperative clinical diagnosis was correct,of was correct,incisional inflammation mass in one, abdominal wall tumor in one and appendicitis in one. All patients underwent wide local excision of the mass,which was revealed by histology to be endometrioma.There was no recurrence and malignancy at clinical follow-up (5 mo nths-10 years). Conclusion AWE near cesarean delivery sca rs is the most common site of extrapelvic endometriosis, commonly presents as an abdominal mass with cyclic or noncyclical symptoms.Imaging techniques are nonsp ecific, but sonographic examination when properly combined with clinical data ma y substantially contribute to the correct preoperative diagnosis of AWE,and need le biopsy may confirm the diagnosis. Wide local excision is the best choice for treatment AWE as well as for the prevention of recurrence.