Abdominal wall endometrioma mimicking an incarcerated hernia

Dimitrios Babalis, Chr. Simoglou
In: Hellenic Journal of Surgery · 2012 · vol. 84(4) , pp. 263–266 · doi:10.1007/s13126-012-0031-z · W2134826641
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This case report describes a tender abdominal wall tumor within a Pfannenstiel incision, mimicking an incarcerated hernia, which was diagnosed as endometrioma via histology.

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This paper reports a case of a 39-year-old woman with a tender isolated abdominal wall tumor in a Pfannenstiel incision, attributed to endometrial tissue seeding after a prior cesarean section despite no history of pelvic endometriosis. The lesion clinically mimicked an incarcerated incisional hernia, and the authors note the preoperative differential diagnosis included postoperative tender granuloma and the remote possibility of an incisional endometrioma, with malignancy not considered a serious concern; they also state no menstrual linkage was identified. The excised lesion was definitively diagnosed by histology, and the authors present the diagnostic dilemma along with a brief literature review. This paper is centrally about endometriosis — specifically an abdominal wall endometrioma in a cesarean scar that mimicked an incarcerated hernia.

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Abstract

We present the case of a tender, isolated abdominal wall tumour within a Pfannenstiel incision, due to seeding deposit of endometrial tissue secondary to a previous obstetric operation (caesarean section) in a 39-year-old female without reported previous pelvic endometriosis. The lesion clinically mimicked the appearance of an incarcerated incisional hernia at the outer corner of the healed Pfannenstiel incision. The preoperative differential diagnosis also included that of a locally forming postoperative tender granuloma and the remote possibility of an incisional endometrioma (although no link to menstruation could be made). Local malignancy was not taken as a serious possibility. Definitive diagnosis of the excised lesion was made at histology. The preoperative diagnostic dilemma is presented, along with a short review of the literature. Similar content being viewed by others

References

Incisional subcutaneous endometrioma of the abdominal wall, Merran S, Karila-Cohen P. J Radiol. 2004; April; 85(4 Pt 1):409–410 Abdominal wall endometriosis. Case report and literature review. Ceniceros Franco G, Cruz Minoli V, Diaz Arguello D, Munuzuri Iniguez F.Ginecol Obstet Mex. 2002: Dec;70:619–621 Endometriosis of the abdominal wall: Donati M, Gandolfo L, Cavallaro G, Ciancio F, Brancato G. Ann Ital Chir. Jan–Feb; 2004:75(1):29–34 Abdominal wall endometriosis: case report Velez SE, Piccinni DJ, Caminos S, Spittle LS, Ferrari JC. Rev Fac Cien Med Univ Nac Cordoba. 2004(1):61:44–47 Abdominal wall endometriomas. Blanco RG, Parithivel VS, Shah AK, Gumbs MA, Schein M, Gerst PH. Am J Surg. 2003: Jun;185(6):596–598 Clinical characteristics of abdominal wall endometrioma and its recurrence-related factors, Zhao XY, Lang JH, Leng JH, Liu ZF, Li HJ, Sun DW, Zhu L., Zhonghua Fu Chan Ke Za Zhi. 2004 Feb;39(2):97–100 Abdominal wall endometriosis. An overlooked diagnosis. Khammash MR, Omari AK, Gasaimeh GR, Bani-Hani KE. Saudi Med J. 2003 May;24(5):523-5 Endometriosis implant in cesarean section surgical scar, Esquivel-Estrada V, Briones-Garduno JC, Mondragon-Ballesteros R. Cir Cir. 2004:Mar–Apr;72(2):113–115 Extrauterine endometriosis: three new cases, Capasso L, Sciano D, Iarrobino G, Ventriglia R, Schiavone F, Buonomo C, Rossi T, Borsi E., G Chir 2004 Jan–Feb;25(1–2):39–42 Endometriosis in the differential diagnosis of abdominal wall masses. Divani S, Vardouli A, Exarhos N, Lioupis A. Acta Cytol. 2003:47:944–945 Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Babalis, D., Simoglou, C. Abdominal wall endometrioma mimicking an incarcerated hernia. Hellenic J Surg 84, 263–266 (2012). https://doi.org/10.1007/s13126-012-0031-z Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s13126-012-0031-z

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