Endometriosis en localización inusual: Reporte de un caso

Karla Alexandra Andrade Ruiz, Hugo Marcelo Garzón Ávila, Katterin Lisset Romero Bello, Saskia Josefa Mendoza García
In: Metro Ciencia · 2021 · vol. 29(2) , pp. 55–58 · doi:10.47464/metrociencia/vol29/2/2021/55-58 · W3185859661
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This case report describes a rare instance of endometriosis found in a prior appendectomy scar, confirmed histopathologically and suggested by ultrasound imaging.

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The paper reports a rare case of endometriosis occurring in the scar of a prior appendectomy, highlighting that endometriosis outside the uterine cavity can present with nonspecific symptoms that make preoperative diagnosis challenging and lead to underdiagnosis. It describes a clinical picture considered classic and imaging findings on ultrasound that were suggestive, with definitive confirmation achieved by histopathology after evaluation. A key caveat is that diagnosis of scar endometriosis is difficult preoperatively, despite the potential utility of ultrasound, CT, and MRI, because the clinical presentation is not specific. This paper is centrally about endometriosis — specifically, endometriosis in an unusual abdominal wall (appendectomy) surgical scar.

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Abstract

La endometriosis en la cicatriz de cirugía previa es una entidad poco común. La endometriosis es la presencia de tejido endometrial fuera de la cavidad uterina. Su diagnóstico preoperatorio es un desafío debido a la clínica inespecífica que puede presentar y, por lo tanto, es subdiagnosticada. La mayoría de los casos se presentan posterior a cirugías obstétricas o ginecológicas. Aunque el diagnóstico definitivo es confirmado por histopatología, las imágenes preoperatorias, como la ecografía, tomografía computarizada y resonancia magnética, pueden resultar útiles para la valoración. Se presenta un caso de endometriosis en cicatriz de apendicetomía previa, confirmada a través del estudio histopatológico, que se acompañó de una presentación clínica clásica e imágenes ecográficas sugestivas.
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Endometriosis en localización inusual: Reporte de un caso DOI: https://doi.org/10.47464/MetroCiencia/vol29/2/2021/55-58Palabras clave: Endometriosis, apendicectomía, pared abdominal, reporte de casoResumen La endometriosis en la cicatriz de cirugía previa es una entidad poco común. La endometriosis es la presencia de tejido endometrial fuera de la cavidad uterina. Su diagnóstico preoperatorio es un desafío debido a la clínica inespecífica que puede presentar y, por lo tanto, es subdiagnosticada. La mayoría de los casos se presentan posterior a cirugías obstétricas o ginecológicas. Aunque el diagnóstico definitivo es confirmado por histopatología, las imágenes preoperatorias, como la ecografía, tomografía computarizada y resonancia magnética, pueden resultar útiles para la valoración. Se presenta un caso de endometriosis en cicatriz de apendicetomía previa, confirmada a través del estudio histopatológico, que se acompañó de una presentación clínica clásica e imágenes ecográficas sugestivas. Descargas Citas Practice bulletin no.114: Management of endometriosis [Internet]. Vol. 116, Obstetrics and Gynecology. Obstet Gynecol; 2010 [cited 2020 Sep 28]. p. 223–36. Available from: https://pubmed.ncbi.nlm.nih.gov/20567196/ Aydin Ö. Scar endometriosis - A gynaecologic pathology often presented to the general surgeon rather than the gynaecologist: Report of two cases. Langenbeck’s Arch Surg [Internet]. 2007 Jan [cited 2020 Oct 2];392(1):105–9. Available from: https://pubmed.ncbi.nlm.nih.gov/17043902/ Amini M, Moghbeli M. Appendectomy Scar Endometriosis: A Case Report. Middle East J Dig Dis [Internet]. 2018 Mar 14 [cited 2020 Oct 2];10(2):114–6. Available from: /pmc/articles/PMC6040921/?report=abstract CARE Case Report Guidelines [Internet]. [cited 2020 Oct 17]. Available from: https://www.care-statement.org/ Ulukus M, Cakmak H, Arici A. The Role of Endometrium in Endometriosis [Internet]. Vol. 13, Journal of the Society for Gynecologic Investigation. J Soc Gynecol Investig; 2006 [cited 2020 Oct 3]. p. 467–76. Available from: https://pubmed.ncbi.nlm.nih.gov/16990031/ Blanco RG, Parithivel VS, Shah AK, Gumbs MA, Schein M, Gerst PH. Abdominal wall endometriomas. Am J Surg [Internet]. 2003 Jun 1 [cited 2020 Oct 2];185(6):596–8. Available from: https://pubmed.ncbi.nlm.nih.gov/12781893/ Khan Z, Zanfagnin V, El-Nashar SA, Famuyide AO, Daftary GS, Hopkins MR. Risk Factors, Clinical Presentation, and Outcomes for Abdominal Wall Endometriosis. J Minim Invasive Gynecol [Internet]. 2017 Mar 1 [cited 2020 Oct 5];24(3):478–84. Available from: http://dx.doi.org/10.1016/j.jmig.2017.01.005 Zondervan KT, Becker CM, Missmer SA. Endometriosis [Internet]. Longo DL, editor. Vol. 382, New England Journal of Medicine. Massachussetts Medical Society; 2020 [cited 2020 Sep 28]. p. 1244–56. Available from: http://www.nejm.org/doi/10.1056/NEJMra1810764 Kocher MR, Hardie A, Schaefer A, McLaren T, Kovacs MD. Cesarean-Section Scar Endometrioma: A Case Report and Review of the Literature. J Radiol Case Rep [Internet]. 2017 Dec 17 [cited 2020 Oct 3];11(12):8–15. Available from: http://www.radiologycases.com/index.php/radiologycases/article/view/3178 Tatli F, Gozeneli O, Uyanikoglu H, Uzunkoy A, Yalcın HC, Ozgonul A, et al. The clinical characteristics and surgical approach of scar endometriosis: A case series of 14 women. Bosn J Basic Med Sci [Internet]. 2018 [cited 2020 Oct 5];18(3):275–8. Available from: https://pubmed.ncbi.nlm.nih.gov/29285999/ Alnafisah F, Dawa SK, Alalfy S. Skin Endometriosis at the Caesarean Section Scar: A Case Report and Review of the Literature. Cureus [Internet]. 2018 Jan 14 [cited 2020 Oct 5];10(1). Available from: https://pubmed.ncbi.nlm.nih.gov/29545986/ Publicado Cómo citar Número Sección Licencia Derechos de autor 2021 Karla Alexandra Andrade Ruiz Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.

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