Perineal endometriosis: a rare case of a unique sizeable nodule: a case report

Hana Hakim, Sawssan Ben Halima, Ahmed Zouari, Dora Trabelsi, Mohamed Derbel, Kais Chaabane, Sahbi Kebaili, Sahbi Kebaïli
The Pan African medical journal · 2021 · vol. 38 , pp. 47 · doi:10.11604/pamj.2021.38.47.27737 · PMID:33854676 · W3123017053
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This case report details a rare instance of perineal endometriosis presenting as a sizable nodule in an episiotomy scar, which was diagnosed via imaging and successfully treated surgically.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This paper reports a 34-year-old woman with a painful, cyclic perineal swelling and a sizeable mass arising in an old mediolateral episiotomy scar after two vaginal deliveries; diagnosis was evaluated using physical exam, ultrasonography, and MRI, which showed no other endometriosis locations. The authors initially used hormonal therapy with dienogest for three months, but the nodule size did not decrease and pain persisted, prompting complete surgical excision with electrosection and a margin of healthy tissue. Histopathology confirmed endometriosis (fibroadipose tissue with glandular structures and endometrial epithelium/stroma) and showed no malignancy; the patient had no immediate complications and remained asymptomatic with no recurrence at 6 months and 1 year. This paper is centrally about endometriosis — it is a case report specifically focused on perineal endometriosis in an episiotomy scar.

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Abstract

Endometriosis is the presence of endometrial tissue in abnormal locations outside the uterine cavity. These locations are usually the ovaries, the peritoneum, and the uterine ligaments. Less frequently, the endometrial tissue can affect the perineum especially after surgical procedures or obstetric lesions. In this case report, we describe the case of a patient suffering from pain and swelling, with a sizeable nodule in an old episiotomy scar. Clinical examination, ultrasonography (USG) and magnetic resonance imaging (MRI) helped evoke the diagnosis of perineal endometriosis, and there were no signs of other endometriosis locations. Hormonal treatment was provided at first, but there was no clinical improvement after three months, so the treatment had to be surgical. Histopathological examination of the endometriotic mass confirmed the diagnosis. There were no immediate postoperative complications, and no clinical symptoms or recurrence signs six months and one year after.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Cicatrix Endometriosis Perineum Adult Cicatrix Endometriosis Endometriosis Episiotomy Episiotomy Female Humans Magnetic Resonance Imaging Pain Pain Perineum

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (9)

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