Caesarean section scar endometriosis: A case report and review of the literature with special emphasis on malignant transformation

Hubert Daisley, Stacey Trim, Alicia R. Daisley
In: Our Dermatology Online · 2018 · vol. 9(2) , pp. 176–179 · doi:10.7241/ourd.20182.19 · W2795598657
article OA: diamond CC0 ⤵ 2 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This case report and literature review highlights the occurrence of implantation endometriosis in Pfannenstiel scars after caesarean hysterectomy, emphasizing its premalignant potential.

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

This case report and literature review describes a 30-year-old woman with a painful lump in her Pfannenstiel caesarean section scar that persisted for over one year; she underwent excision biopsy, and histology showed endometriosis within the scar tissue. The authors frame this as implantation endometriosis following uterine surgery and discuss diagnostic options and the broader concept that endometriosis can undergo malignant transformation, noting that the true incidence is unknown and incidence estimates vary, with a cited figure of ~1% of women having malignant transformation of lesions. They review reports of malignant transformation arising in extra-ovarian sites including caesarean scars and emphasize that endometriosis is described as a precancerous condition with an emphasis on the premalignant potential and transformation risk at implantation sites. This paper is centrally about endometriosis — it specifically reports caesarean section scar (incisional) endometriosis and highlights malignant transformation risk.

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Abstract

Implantation endometriosis following caesarian hysterectomy is not an uncommon entity. Seeding of endometrium within the peritoneum and pelvic organs and the Pfannenstiel incision commonly occur. Post caesarean implantation endometriosis occurrence is determined by several factors. While endometriosis is a morbid disease, which causes pain, dysfunctional uterine bleeding and infertility, it is also a precancerous condition, and efforts should be made to avoid implantation endometriosis during uterine surgery. The object of this article is to present a 30 year old female with implantation endometriosis in a Pfannenstiel abdominal scar and to review the diagnostic facilities available and highlight the premalignant potential of endometriosis.

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endometriosisinfertility

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