Endometrioma of the Abdominal Wall after Caesarean Section

Carmine Carriero, Miriam Dellino, Teresa Capursi, Gennaro Cormio
In: Open Journal of Obstetrics and Gynecology · 2017 · vol. 07(08) , pp. 907–914 · doi:10.4236/ojog.2017.78091 · W2747855524
article OA: diamond CC0 ⤵ 2 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This case study describes a 36-year-old woman with an abdominal wall endometrioma distant from her prior C-section scar, which was diagnosed via MRI and confirmed by intraoperative frozen section, requiring mesh grafting for reconstruction.

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Abstract

Background: Endometrial cell implantation after abdominal surgery, mainly after caesarean section, may result in formation of endometrioma, which is usually described to be of various sizes, and adjacent to the surgical scar. Case: A 36-year old woman complaining of a mass of the abdominal wall with pain during the menstrual period, with a caesarean section 5 years earlier, presented a rounded tumour not contiguous to the Pfannenstiel’s laparotomy scar, of hard consistence, fixed and adherent to the deep abdominal wall structures, located on the left paramedian epigastric region. Magnetic Resonance imaging showed the nodule, involving the deep layers of the abdominal wall and the distance from the laparotomic scar. Surgical removal was performed with wide excision of the lesion, causing a large wall defect. After histological confirmation (endometriosis) by frozen section, reconstruction of the abdominal wall required prolene mesh grafting. After twelve months the patient is healthy. Conclusion: When abdominal wall endometrioma is located distant from the scar, perhaps more frequently after Pfannenstiel’s laparotomic incision, the differential diagnosis may be more difficult and MRI can help differentiating many of these lesions, and histological confirmation should be obtained intraoperatively, by frozen section, to allow an oncological resection if required.

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endometriosisendometrioma

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