Application of Mini-abdominoplasty after Conservative Excision of Extensive Cesarean Scar Endometriosis

Subscribe to RSS DOI: 10.5999/aps.2012.39.5.551 Application of Mini-abdominoplasty after Conservative Excision of Extensive Cesarean Scar Endometriosis Authors Endometriosis is defined as the presence of functioning endometrial tissue outside the uterine cavity, and the standard treatment is extensive surgical excision. Cesarean scar endometriosis is a type of cutaneous endometriosis arising on or near a Cesarean section scar. A 44-year-old woman presented with a 9×6 cm sized dark-brown, stony-hard, irregular, lower abdominal mass of four years duration. The patient had a history of two Cesarean deliveries, 14 and 16 years ago. Suspecting endometriosis, we excised the tumor conservatively rather than extensively to prevent incisional hernia considering the benign nature of the tumor and the low possibility of recurrence because the patient's age was near menopause, along with simultaneous bilateral salpingo-oophorectomy that was performed in this case. On reconstruction, mini-abdominoplasty was adopted to avoid possible wound complications and cosmetic deformities. The patient was satisfied with the cosmetic results, and neither recurrence nor functional problems occurred during the 1-year follow-up period. Plastic surgeons should keep in mind the possibility of cutaneous endometriosis in an abdominal mass of a female of reproductive age with a previous history of pelvic or intra-abdominal surgery. An optimal result from oncological, functional, and cosmetic standpoints can be achieved with conservative excision followed by mini-abdominoplasty of extensive Cesarean scar endometriosis. This work was supported by a research grant from Chungbuk National University in 2011. Publication History Received: 14 May 2012 Accepted: 02 August 2012 Article published online: 01 May 2022 © 2012. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/) Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USA - REFERENCES - 1 Gajjar KB, Mahendru AA, Khaled MA. Caesarean scar endometriosis presenting as an acute abdomen: a case report and review of literature. Arch Gynecol Obstet 2008; 277: 167-169 - 2 Francica G, Giardiello C, Angelone G. et al. Abdominal wall endometriomas near cesarean delivery scars: sonographic and color doppler findings in a series of 12 patients. J Ultrasound Med 2003; 22: 1041-1047 - 3 Wolf GC, Singh KB. Cesarean scar endometriosis: a review. Obstet Gynecol Surv 1989; 44: 89-95 - 4 Kim JK, Cha SI, Lee YS. et al. A case of primary cutaneous endometriosis at the unbilicus. Korean J Obstet Gynecol 2005; 48: 1064-1068 - 5 Yi TM, Kim YJ, Kim SG. et al. A case of endometrioma at the abdominal scar. J Korean Soc Plast Reconstr Surg 2010; 37: 843-846 - 6 Hong HJ, Chung BS, Son EJ. et al. Abdominal wall endometriosis after Cesarean section: a report of two cases. Korean J Obstet Gynecol 2005; 48: 228-233 - 7 Jeong YJ, Kim JC. Endometrioma in the abdominal incisional scar. J Korean Surg Soc 2003; 65: 259-262 - 8 Kang AR, Hur JY. Medical therapy of endometriosis. J Korean Med Assoc 2010; 53: 424-429 - 9 Elbiss HM, Thomson AJ. The management of stage III and IV endometriosis. Arch Gynecol Obstet 2012; 285: 387-396 - 10 Falcone T, Lebovic DI. Clinical management of endometriosis. Obstet Gynecol 2011; 118: 691-705 - 11 Schindler AE. Hormonal contraceptives and endometriosis/adenomyosis. Gynecol Endocrinol 2010; 26: 851-854 - 12 Sim HB, Yoon SY. Experiences of abdominoplasty without undermining. J Korean Soc Plast Reconstr Surg 2006; 33: 303-307