A Rare Case of Scar Edometriosis - Case Report

L Sridhar; Abhilash Reddy K.; Bhaswanth Dhoorjati; Rohit Phadnis

doi:10.32553/ijmbs.v7i1.2654

A Rare Case of Scar Edometriosis - Case Report

L Sridhar, Abhilash Reddy K., Bhaswanth Dhoorjati, Rohit Phadnis

In: International Journal of Medical and Biomedical Studies · 2023 · vol. 7(1) , pp. 19–22 · doi:10.32553/ijmbs.v7i1.2654 · W4317786891

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This case report describes a 34-year-old female with cyclic pain and a lump at a Pfannenstiel incision, confirmed by HPE to be scar endometriosis, a rare condition treated by surgical excision.

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This case report describes a 34-year-old woman with cyclic menstruation-associated pain at a Pfannenstiel incision scar, with a 5×5 cm abdominal wall lump after prior obstetric procedure, where preoperative assessment suggested scar endometriosis. The lesion was excised and histopathological examination confirmed scar endometriosis with 2 cm clear margins. The authors note scar endometriosis is rare (incidence reported as 0.03–0.45%) and emphasize that histopathology is needed to support the iatrogenic implantation theory, while also acknowledging the limitation inherent to a single case report. This paper is centrally about endometriosis — it specifically reports a rare case of scar endometriosis at a surgical incision site.

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Abstract

Background: Scar endometriosis is a rare condition seen in post LSCS or hysterectomy or obstetric procedure, where functional endometrial tissue is seen outside uterine cavity. Case: A 34 year old female presented with cyclic pain during menstruation at the Pfannenstiel incision at the scar site, associated with 5 * 5 cm lump in the parietal abdominal plan. On clinical examination and investigations, preoperatively, it was suggestive of scar endometriosis. After excision, HPE confirmed to be scar endometriosis with 2 cm clear margins. Discussion: Scar endometriosis is a very rare disorder whose incidence was reported to be 0.03–0.45%. Clinical suspicion of scar endometriosis is very important in the patients with chronic pain at scar site, which is usually missed and can often lead to longterm morbidity of the patients. With histopathological confirmation it becomes absolutely necessary to prove iatrogenic implantation theory which is well accepted. Conclusion: Clinical suspicion of scar endometriosis depending on clinical presentation and history of previous obstetric procedure is important for surgeons and excision of the lesion with good margins is the treatment of choice to prevent chronic morbidity in patients due to pain and recurrent surgery.

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Background

Scar endometriosis is a rare condition seen in post LSCS or hysterectomy or obstetric procedure, where functional endometrial tissue is seen outside uterine cavity. Case: A 34 year old female presented with cyclic pain during menstruation at the Pfannenstiel incision at the scar site, associated with 5 * 5 cm lump in the parietal abdominal plan. On clinical examination and investigations, preoperatively, it was suggestive of scar endometriosis. After excision, HPE confirmed to be scar endometriosis with 2 cm clear margins.

Discussion

Scar endometriosis is a very rare disorder whose incidence was reported to be 0.03–0.45%. Clinical suspicion of scar endometriosis is very important in the patients with chronic pain at scar site, which is usually missed and can often lead to longterm morbidity of the patients. With histopathological confirmation it becomes absolutely necessary to prove iatrogenic implantation theory which is well accepted.

Conclusion

Clinical suspicion of scar endometriosis depending on clinical presentation and history of previous obstetric procedure is important for surgeons and excision of the lesion with good margins is the treatment of choice to prevent chronic morbidity in patients due to pain and recurrent surgery. Downloads Published How to Cite Issue Section License Copyright (c) 2023 International Journal of Medical and Biomedical Studies This work is licensed under a Creative Commons Attribution 4.0 International License.

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