Scar endometriosis: an uncommon surgical aftermath

Sumedha Pathade, Shruti Panchbudhe, Prasad Deshmukh, Arun Nayak
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2022 · vol. 11(3) , pp. 947 · doi:10.18203/2320-1770.ijrcog20220584 · W4214668634
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-08 ⓘ

This case report describes a 35-year-old woman who presented with cyclical pain and swelling over a Cesarean section scar, which was diagnosed as scar endometriosis via histopathology after surgical excision.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 · read from full text ⓘ

This paper describes an uncommon case of abdominal scar endometriosis occurring as a surgical aftermath after a prior caesarean section, in a 35-year-old woman who developed a tender swelling over the scar site with cyclical pain during menses. The authors report that ultrasonography showed a firm mass that was removed by wide local excision, and histopathology confirmed the diagnosis by demonstrating endometrial glands, stroma, and hemosiderin-laden macrophages. The main limitation is that the report provides a single-case description rather than systematic data. This paper is centrally about endometriosis — specifically scar endometriosis following caesarean section.

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Abstract

Endometriosis is a benign condition wherein endometrial tissue lies outside the uterine cavity. Abdominal scar endometriosis is a rare entity following pelvic surgeries caused as a result of deposition of endometrial tissue at scar site. Patient usually presents with triad of presence of mass over scar site, cyclical pain during menses and bleeding. Histopathological examination remains gold standard for diagnosis in which the presence of endometrial glands, stroma and hemosiderin laden macrophages can be seen. We presented a case of 35 years old lady with history of caesarean section done 3 years back who came with complaints of swelling over the scar site and cyclical pain with tenderness present over lump. Ultrasonography revealed presence of firm mass which was removed by wide local excision and histopathology confirmed the diagnosis of scar endometriosis.
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Scar endometriosis: an uncommon surgical aftermath DOI: https://doi.org/10.18203/2320-1770.ijrcog20220584Keywords: Scar endometriosis, LSCS, Rectus sheathAbstract Endometriosis is a benign condition wherein endometrial tissue lies outside the uterine cavity. Abdominal scar endometriosis is a rare entity following pelvic surgeries caused as a result of deposition of endometrial tissue at scar site. Patient usually presents with triad of presence of mass over scar site, cyclical pain during menses and bleeding. Histopathological examination remains gold standard for diagnosis in which the presence of endometrial glands, stroma and hemosiderin laden macrophages can be seen. We presented a case of 35 years old lady with history of caesarean section done 3 years back who came with complaints of swelling over the scar site and cyclical pain with tenderness present over lump. Ultrasonography revealed presence of firm mass which was removed by wide local excision and histopathology confirmed the diagnosis of scar endometriosis. Metrics References Wolf GC, Singh KB. Cesarean scar endometriosis: a review. Obstet Gynecol Surv. 1989;44(2):89-95. Padmanabhan LD, Mhaskar R, Mhaskar A. Scar endometriosis. J Obstet Gynaecol India. 2003;53:59-61. Chatterjee SK. Scar endometriosis: a clinicopathological study of 17 cases. Obstet Gynecol. 1980;56:81-4. Wolf Y, Haddad R, Werbin N, Skornick Y, Kaplan O. Endometriosis in abdominal scars: a diagnostic pitfall. Am Surg. 1996;62(12):1042-4. Ding DC, Hsu S. Scar endometriosis at the site of cesarean section. Taiwan J Obstet Gynecol. 2006;45(3):247-9. Sengul I, Sengul D, Kahyaoglu S, Kahyaoglu I. Incisional endometriosis: a report of 3 cases. Can J Surg. 2009;52(5):444-5. Gupta P, Gupta S. Scar Endometriosis: a Case Report with Literature Review. Acta Med Iran. 2015;53(12):793-5. Francica G, Giardiello C, Angelone G, Cristiano S, Finelli R, Tramontano G. Abdominal wall endometriomas near cesarean delivery scars: sonographic and color Doppler findings in a series of 12 patients. J Ultrasound Med. 2003;22:1041-7. Gupta RK, Naran S. Aspiration cytodiagnosis of endometriosis in an abdominal scar after caesarean section. Acta Cytol. 1995;39:603-4. Horton JD, Dezee KJ, Ahnfeldt EP, Wagner M. Abdominal wall endometriosis: a surgeon’s perspective and review of 445 cases. Am J Surg. 2008;196:207-12. Bozkurt M, Çil AS, Bozkurt DK. Intramuscular abdominal wall endometriosis treated by ultrasound-guided ethanol injection. Clin Med Res. 2014;12(3):160-5.

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