Incisional Endometriosis: A Rare Case of Painful Scar

Nalini Sharma, Thiek Jion Lalnunnem, Khonglah Yookerine, Ahanthem Santa Singh
In: Journal of Midwifery & Reproductive Health, Vol 5, Iss 2, Pp 927-929 (2017) · 2017 · doi:10.22038/jmrh.2017.8212 · W2594708892
article OA: green CC0 ⤵ 6 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This case report describes a rare instance of painful scar endometriosis, diagnosed preoperatively by fine-needle aspiration cytology, which is often confirmed by histology and treated with surgical excision.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 ⓘ

This paper reports a rare case of incisional (scar) endometriosis presenting as a painful lump at a prior surgical site, and describes diagnosis made preoperatively using fine-needle aspiration cytology. The authors discuss proposed mechanisms, noting direct mechanical implantation after uterine surgery as the most plausible theory, and emphasize that endometriosis is often not considered until histology is performed, implying a diagnostic challenge. The report states that wide surgical excision with at least a 1 cm margin is the recommended treatment and that mandatory histopathological examination is important due to a rare risk of malignant transformation, with follow-up advised to detect recurrence. This paper is centrally about endometriosis — specifically incisional scar endometriosis after uterine surgery.

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Abstract

Scar endometriosis is a rare form of extra-pelvic endometriosis that can occur after surgery involving the uterus. Direct mechanical implantation seems to be the most conceivable theory for scar endometriosis. Patient usually presents with lump and pain at surgical site. Often the diagnosis of endometriosis is not suggested until histology has been performed. We hereby present a case of scar endometriosis diagnosed preoperatively by fine-needle aspiration cytology. Scar endometriosis is a rare cause of painful scar; therefore, high index of suspicion is suggested in clinching the diagnosis. The recommended treatment is wide surgical excision with at least 1 cm margin on all sides. While performing lower segment caesarean section some preventive measures should be taken to prevent its occurrence. Histopathological examination is mandatory, as there is rare possibility of malignant transformation. Follow-up is advisable to diagnose recurrence.vv

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endometriosis

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