Abdominal-wall Endometriosis Occurring at the Wound Site after a Caesarian Section

Ryuta Taniguchi, Noritaka Minagawa, Koji Onitsuka, Yoshitaka Sakamoto
In: Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons) · 2019 · vol. 44(2) , pp. 327–331 · doi:10.4030/jjcs.44.327 · W3022816749
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This case report describes a 47-year-old woman with abdominal-wall endometriosis at a caesarean section scar, presenting as recurrent tumors with cyclical pain, treated by surgical excision.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This case report describes a 47-year-old woman who developed abdominal-wall endometriosis at a cesarean section scar after prior umbilical hernia and an umbilical tumor resection in her late 30s, with diagnosis based on pathology. At age 44, she presented with cyclical lower abdominal pain and palpable tumors along the cesarean scar; imaging (contrast CT and MRI) showed invasion into the rectus abdominis muscle and blood components within the masses, leading the authors to suspect abdominal-wall endometriosis. Core-needle biopsy was not performed due to concern about tumor re-implantation and dissemination, and surgical excision removed both tumors with surrounding tissues. Pathology confirmed endometriosis with glands and endometrial stroma, and the paper notes that most abdominal-wall endometriosis occurs in operative scars after cesarean sections. This paper is centrally about endometriosis — it reports abdominal-wall endometriosis occurring specifically at a cesarean section wound site.

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Abstract

A 47-year-old woman underwent caesarian section at the age of 23 and 33. Subsequently, she underwent another operation for an umbilical hernia and abdominal-wall tumor of umbilicus when she was 39 years old. Abdominal-wall endometriosis of umbilicus was diagnosed based on the results of pathological examination. There was no post-operative recurrence. At the age of 44 years, two abdominal-wall tumors with cyclical lower abdominal pain were observed in the lower abdominal region. She presented with pain at our hospital and had a palpable abdominal-wall tumor along the caesarian section scar. Tumors were another legions at the age of 39 years. Contrast-enhanced computed tomography revealed that the two tumors had invaded the rectus abdominis muscle. Both tumors were 35 mm in size. Magnetic resonance imaging revealed blood component into tumors. We suspected abdominal-wall endometriosis based on these findings. Core-needle biopsy was not performed due to the risk of re-implantation and dissemination. Surgical excision was used to remove the tumors along with some surrounding tissues. Pathological analysis revealed that the tumors consisted of endometriosis with glands and endometrial stroma. Approximately 79％ of abdominal-wall endometriosis occurs in the operative scar after a caesarian section. As there are no treatment guidelines, wide excision with normal tissue surrounding the tumor is recommended.

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endometriosis

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