Surgical scar endometriosis

Massimiliano Mistrangelo, Nicholas Gilbo, Paola Cassoni, Cassoni P, Micalef S, Salvatore Micalef, Riccardo Faletti, Miglietta C, C Miglietta, Claudio Miglietta, Brustia R, Raffaele Brustia, Bonnet G, Gisella Bonnet, Gregori G, Gianluca Gregori, G. Gregori, Mario Morino
Surgery today · 2013 · vol. 44(4) , pp. 767–772 · doi:10.1007/s00595-012-0459-3 · PMID:23307296 · W2086704308
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⚙ AI-generated summary by gemini-2.5-flash-lite+body, 2026-06-12 ⓘ

This observational study reviewed five patients with scar endometriosis, confirming the diagnosis histologically and noting recurrence in two cases, highlighting surgery as the treatment of choice.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text ⓘ

This retrospective observational cohort study reviewed medical records of five patients with histopathologically confirmed surgical scar endometriosis, examining prior Pfannenstiel or median cesarean incisions and clinical course over a mean 34.6-month follow-up. A tender, painful abdominal wall mass at the previous incision site was found in four patients (and in one patient associated with a median cesarean section), with diagnosis supported by histology in all cases; mean age at diagnosis was 38.6 years. During follow-up, there was local recurrence in one patient and pelvic recurrence in another, treated surgically, and the authors state that surgery is the treatment of choice with excision and histologically proven free margins of 1 cm as mandatory, with possible exploratory laparoscopy in symptomatic cases due to potential pelvic association. This paper is centrally about endometriosis — specifically surgical scar endometriosis after cesarean section and its diagnosis and recurrence.

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Abstract

Endometriosis is a common disorder in females of reproductive age. Surgical scar endometrioma after cesarean section develops in 1-2% of patients, and usually presents as a tender and painful abdominal wall mass. The diagnosis is suggested by pre or perimenstrual pelvic pain and is often established only by histology. In this retrospective observational cohort study, we reviewed the medical records of five patients with a histopathological diagnosis of scar endometriosis. A scar mass was found on a previous Pfannenstiel incision in four patients and in a median cesarean section in one patient. The mean age at diagnosis (38.6 years, median 38) was older than reported elsewhere. A histological examination of the surgical specimen confirmed the diagnosis of endometriosis in all cases. During the follow-up period (mean 34.6 months), local recurrence (n = 1) and pelvic recurrence (n = 1) were treated surgically. Surgery is the treatment of choice for surgical scar endometriosis. Excision with histologically proven free surgical margins of 1 cm is mandatory to prevent recurrence. As scar endometriosis may be associated with pelvic localization, explorative abdominal laparoscopy may be indicated to exclude the intraperitoneal spread of the disease in symptomatic patients.
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Abstract

Endometriosis is a common disorder in females of reproductive age. Surgical scar endometrioma after cesarean section develops in 1–2 % of patients, and usually presents as a tender and painful abdominal wall mass. The diagnosis is suggested by pre or perimenstrual pelvic pain and is often established only by histology. In this retrospective observational cohort study, we reviewed the medical records of five patients with a histopathological diagnosis of scar endometriosis. A scar mass was found on a previous Pfannenstiel incision in four patients and in a median cesarean section in one patient. The mean age at diagnosis (38.6 years, median 38) was older than reported elsewhere. A histological examination of the surgical specimen confirmed the diagnosis of endometriosis in all cases. During the follow-up period (mean 34.6 months), local recurrence (n = 1) and pelvic recurrence (n = 1) were treated surgically. Surgery is the treatment of choice for surgical scar endometriosis. Excision with histologically proven free surgical margins of 1 cm is mandatory to prevent recurrence. As scar endometriosis may be associated with pelvic localization, explorative abdominal laparoscopy may be indicated to exclude the intraperitoneal spread of the disease in symptomatic patients.

References

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Condition tags

endometriosis

MeSH descriptors

Cicatrix Endometriosis Endometriosis Peritoneal Diseases Peritoneal Diseases Abdominal Pain Abdominal Pain Abdominal Wall Adult Cesarean Section Cesarean Section Cicatrix Cohort Studies Endometriosis Endometriosis Female Humans Laparoscopy Peritoneal Diseases Peritoneal Diseases

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