Abdominal wall mass suspected of endometriosis: clinical and pathologic features

Heekyoung Song, SangHee Lee, Min Jeong Kim, Min-Jeong Kim, Jae Eun Shin, Dae Woo Lee, Hae Nam Lee
Obstetrics & gynecology science · 2020 · vol. 63(3) , pp. 357–362 · doi:10.5468/ogs.2020.63.3.357 · PMID:32489981 · PMC7231946 · W3014485411
article OA: gold CC0 ⤵ 7 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This study analyzed 38 patients with abdominal wall masses suspicious for endometriosis, finding that while most were endometriosis, 7.9% were malignant and required preoperative biopsy.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective study reviewed 38 patients who underwent surgery for a lower anterior abdominal wall mass suspected to be endometriosis at hospitals in Korea between 2010 and 2017, excluding skin/intraperitoneal masses, lipomas, hernias, and metastases, and analyzing clinical features and permanent pathology. The authors found endometriosis in 35 patients (92.1%), most commonly at prior surgical scars (97.3% had relevant surgery, with 92.1% having a prior cesarean section), but 3 patients (7.9%) had malignancy despite no suspicious findings on CT/MRI; only 7.9% had preoperative fine-needle aspiration biopsy, and none of the malignancies were biopsied. The paper notes limitations including incomplete medical records that prevented collecting resection-margin and follow-up details for all cases. Relevance to endometriosis: this study centrally evaluates abdominal wall endometriosis (including scar-site endometriosis and rare malignant transformation) in patients with suspected anterior abdominal wall endometriosis.

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Abstract

OBJECTIVE: To evaluate the clinical and pathological characteristics of lower anterior abdominal wall masses suspicious for endometriosis. METHODS: A retrospective review of 38 patients who underwent surgery for a lower anterior abdominal wall mass suspicious for endometriosis was performed. Those with skin and intraperitoneal masses, lipomas, hernias, and metastatic malignant masses were excluded. Patient age, body mass index, delivery history, dysmenorrhea, and mass size and location were analyzed. RESULTS: Thirty-seven (97.3%) patients had a relevant surgical history, including 35 (92.1%) with a history of cesarean section (C/S). Among the three patients with no history of C/S, 1 underwent total abdominal and another total laparoscopic hysterectomy, and 1 had no previous surgical history. The mean (±standard deviation) size of the abdominal masses was 3.2±1.2 cm. One patient developed a recurrent mass after excision of abdominal wall endometriosis. Trocar site endometrioma was found in one patient following total laparoscopic hysterectomy. According to the final pathology reports, endometriosis was found in 35 (92.1%) of patients. The remaining 3 patients (7.9%) had malignancy: adenocarcinoma, squamous cell carcinoma, and extra-gastrointestinal stromal tumor. Before surgery, only 3 patients (7.9%) underwent fine-needle aspiration biopsy of the masses, which were all postoperatively confirmed to be pathologically benign. CONCLUSION: Although most abdominal wall masses in the present sample were endometriosis occurring at the scar site from a previous operation, 7.9% of patients ultimately exhibited malignancy. Therefore, all patients with suspected anterior wall endometriosis should undergo preoperative biopsy to identify the few that will have an alternative diagnosis.

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Condition tags

endometriosisendometriomadysmenorrhea

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