A case of scar endometriosis: rare entity

Koluguri Bhavana, S. R. Sheela, Radhika, Poorni Bharath
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2025 · vol. 14(5) , pp. 1674–1675 · doi:10.18203/2320-1770.ijrcog20251267 · W4409878485
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This case report describes scar endometriosis, a rare condition involving endometrial tissue in a post-cesarean section rectus sheath scar, which required surgical excision.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

This paper is a case report describing scar endometriosis occurring in the rectus sheath after a cesarean section, with the authors focusing on clinical features and management. The patient’s condition was discussed in the context of scar endometriosis being rare, often following prior gynecologic or obstetric procedures, and commonly presenting with difficult-to-diagnose symptoms such as cyclic scar pain and swelling. The key finding is that the lesion required surgical excision, and the report discusses the case details and treatment outcome, while noting that prevalence and pathophysiology are not well studied and diagnoses are frequently confused with other conditions. This paper is centrally about endometriosis — it reports a case of scar endometriosis following cesarean section.

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Abstract

Scar endometriosis is a rare and challenging condition characterized by the presence of endometrial tissue outside the uterine cavity, commonly arising in post-surgical scars. This condition typically follows gynecological or obstetric procedures, such as caesarean sections, episiotomies, or hysterectomies, where endometrial cells become implanted and later proliferate within the scar tissue. Symptoms often include cyclic pain and swelling of the scar that correlates with the menstrual cycle, making clinical diagnosis challenging. The prevalence and pathophysiology of scar endometriosis remain under-researched, though it is recognized as an increasingly reported entity due to heightened awareness and diagnostic advances. This surgical condition is usually mistaken with other surgical conditions. The case here reported is a case of scar endometriosis involving rectus sheath after caesarean section. This patient required surgical excision of the scar lesion. The case report, conclusion and treatment of this rare condition are being discussed further.
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A case of scar endometriosis: rare entity DOI: https://doi.org/10.18203/2320-1770.ijrcog20251267Keywords: Endometriosis, Scar ectopic, Previous caesarean sectionAbstract Scar endometriosis is a rare and challenging condition characterized by the presence of endometrial tissue outside the uterine cavity, commonly arising in post-surgical scars. This condition typically follows gynecological or obstetric procedures, such as caesarean sections, episiotomies, or hysterectomies, where endometrial cells become implanted and later proliferate within the scar tissue. Symptoms often include cyclic pain and swelling of the scar that correlates with the menstrual cycle, making clinical diagnosis challenging. The prevalence and pathophysiology of scar endometriosis remain under-researched, though it is recognized as an increasingly reported entity due to heightened awareness and diagnostic advances. This surgical condition is usually mistaken with other surgical conditions. The case here reported is a case of scar endometriosis involving rectus sheath after caesarean section. This patient required surgical excision of the scar lesion. The case report, conclusion and treatment of this rare condition are being discussed further. Metrics References Chen LH, Lo WC, Huang HY, Wu HM. A lifelong impact on endometriosis: pathophysiology and pharmacological treatment. International journal of molecular sciences. 2023;24(8):7503. DOI: https://doi.org/10.3390/ijms24087503 Scioscia M, Virgilio BA, Laganà AS, Bernardini T, Fattizzi N, Neri M, et al. Differential diagnosis of endometriosis by ultrasound: a rising challenge. Diagnostics. 2020;10(10):848. DOI: https://doi.org/10.3390/diagnostics10100848 Teng C. Treatment Outcomes and Recurrence Rates in Scar Endometriosis: A Systematic Review. Journal of Minimally Invasive Gynecology. 2019;26(5):867-75. Veth VB, Keukens A, Reijs A, Bongers MY, Mijatovic V, Coppus SFPJ, et al. Recurrence after surgery for endometrioma: a systematic review and meta-analyses. Fertil Steril. 2024;122(6):1079-93. DOI: https://doi.org/10.1016/j.fertnstert.2024.07.033 Gupta P, Gupta S. Scar Endometriosis: Case Report with Literature Review. Nepal J Obstet Gynaecol. 2014;9(2):55-7. DOI: https://doi.org/10.3126/njog.v9i2.11764 Karapolat B, Kucuk H. A rare cause of abdominal pain: scar endometriosis. Emerg Med Int. 2019;2019(1):2584652. DOI: https://doi.org/10.1155/2019/2584652 Pechenikova VA, Akopyan RA, Danilova AS, Petrovskaia NN. Postoperative scar endometriosis: the clinical course, diagnosis, treatment, and the morphological examination of surgical material. J Obstet Women's Dis. 2022;71(3):21-30. DOI: https://doi.org/10.17816/JOWD103015 Carvalho MJ, Pais AS, Rodrigues Â, Areia AL, Figueiredo-Dias M. Providing new insights into the endometriosis associated cancer arising in episiotomy scars. Ginekologia Polska. 2021;92(3):220-5. DOI: https://doi.org/10.5603/GP.a2020.0177

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