An increasing trend of iatrogenic scar endometriosis after lower segment cesarean section

Nishat Fatema, Dil Anziz Begum, Shirin Fatema, A.K.M Arif Uddin Ahmed
In: International Journal of Case Reports · 2020 · pp. 117 · doi:10.28933/ijcr-2020-01-1505 · W3007669747
article OA: hybrid CC0
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This case report describes a patient with scar endometriosis following cesarean section, managed with surgical excision and hormonal therapy without recurrence.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This case report studied iatrogenic scar endometriosis after lower segment cesarean section, describing a 21-year-old para 2 woman who developed a painful, 1.5×1.5 cm mass at her Pfannenstiel scar about 2.5 years post-cesarean, with tenderness and blood-stained discharge during menstruation. Clinical exam and ultrasound with Doppler showed a heterogeneous hypoechoic vascular lesion with superficial fascial involvement, leading to a provisional diagnosis; the patient underwent wide local excision with a 1 cm margin, and histopathology demonstrated endometrial glands and stroma with hemorrhage in the fibrous scar. Postoperatively, she received combined oral pill therapy for 3 months and had no recurrence during follow-up, though the report notes diagnostic uncertainty and the nonspecific nature/limited confirmatory yield of imaging in general and does not include MRI (a stated alternative). This paper is centrally about endometriosis — specifically iatrogenic cesarean scar endometriosis and its presentation, imaging findings, surgical pathology confirmation, and short-term outcome.

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Abstract

Cesarean scar endometriosis is an uncommon disorder developed due to iatrogenic implantation of endometrial tissues in the cesarean incision site. The frequency of the scar endometriosis is assumed to increase because of the increasing trend of lower segment cesarean section in modern obstetric practice. Cesarean section might be a great risk factor for the development of scar endometriosis due to higher exposure of endometrial cells to the subcutaneous tissue during the procedure. Prevention of decidual cell contamination to the superficial abdominal layers may reduce the occurrence of iatrogenic scar endometriosis. We reported a 21-year old para 2 woman with a history of cesarean section 2.5 years back who presented with a small mass at the middle of the cesarean scar which was associated with pain and blood-stained discharge during menstruation. Based on clinical and USG findings the provisional diagnosis was made scar endometriosis and subsequently we managed her by wide local excision of the lesion followed by adjuvant hormone therapy. No recurrence of scar endometriosis was observed during her follow up period.

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Condition tags

endometriosis

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References (16)

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