Taiwanese Journal of Obstetrics and Gynecology
Volume 45, Issue 3 , Pages 247-249, September 2006

Scar Endometriosis at the Site of Cesarean Section

  • Dah-Ching Ding

      Affiliations

    • Department of Obstetrics and Gynecology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
    • Graduate Institute of Medical Science, Tzu Chi University, Hualien, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Dah-Ching Ding, Department of Obstetrics and Gynecology, Buddhist Tzu Chi General Hospital, 707, Section 3, Chung-Yang Road, Hualien 970, Taiwan
    • ,
  • Senzen Hsu

      Affiliations

    • Department of Obstetrics and Gynecology, Buddhist Tzu Chi General Hospital, Xindian, Taiwan

Accepted 2 May 2006.

Article Outline

Summary 

Objective

Scar endometriosis is a rare condition. We report a case of scar endometriosis occurring at the site of an old cesarean section scar.

Case Report

A 29-year-old multiparous woman complained of painful sensation during menstruation for 2 years that occurred at the site of her cesarean section surgical scar. On examination, there was a firm nodule measuring 2 × 1.5 cm in size at the mid-point of the scar. In view of the possibility of scar endometriosis, the mass was completely excised. Pathologic findings were compatible with scar endometriosis. Postoperatively, danazol was prescribed to prevent recurrence.

Conclusion

A surgical scar becoming painful and swollen during menstruation is the classic symptom of scar endometriosis. Causes include iatrogenic transplantation of endometrium to the surgical wound. Surgical excision is the main treatment. Postoperative GnRH-agonist or danazol may be prescribed to patients with scar endometriosis.

Key Words:  cesarean section , scar endometriosis

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Wolf GC , Singh KB . Cesarean scar endometriosis: a review . Obstet Gynecol Surv . 1989;44:89–95
  2. Rani PR , Soundararaghavan S , Rajaram P . Endometriosis in abdominal scars-review of 27 cases . Int J Gynaecol Obstet . 1991;36:215–218
  3. Revelli A , Modotti M , Ansaldi C , Massobrio M . Recurrent endometriosis: a review of biological and clinical aspects . Obstet Gynecol Surv . 1995;50:747–754
  4. Wang PH , Juang CM , Chao HT , Yu KJ , Yuan CC , Ng HT . Wound endometriosis: risk factor evaluation and treatment . J Chin Med Assoc . 2003;66:113–119
  5. Steck WD , Helwig EB . Cutaneous endometriosis . JAMA . 1965;191:167–170
  6. Tanos V , Anteby SO . Cesarean scar endometriosis . Int J Gynaecol Obstet . 1994;47:163–166
  7. Rovito P , Gittleman M . Two cases of endometrioma in cesarean scars . Surgery . 1986;100:118–120
  8. Miller WB , Melson GL . Abdominal wall endometrioma . AJR Am J Roentgenol . 1979;132:467–468
  9. Amato M , Levitt R . Abdominal wall endometrioma. CT findings . J Comput Assist Tomogr . 1984;8:1213–1214
  10. Wolf GC , Kopecky KK . MR imaging of endometriosis arising in cesarean section scar . J Comput Assist Tomogr . 1989;13:150–152
  11. Wasfie T , Gomez E , Seon S , Zado B . Abdominal wall endometrioma after cesarean section: a preventable complication . Int Surg . 2002;87:175–177
  12. Madsen H , Hansen P , Andersen OP . Endometrioid carcinoma in an operation scar . Acta Obstet Gynecol Scand . 1980;59:475–476
  13. Gucer F , Reich O , Kometter R , Pieber D . Endometrioid carcinoma arising with a scar endometriosis . Eur J Gynaecol Oncol . 1997;18:42–43
  14. Sirito R , Puppo A , Centurioni MG , Gustavino C . Incisional hernia on the 5-mm trocar port site and subsequent wall endometriosis on the same site: a case report . Am J Obstet Gynecol . 2005;193:878–880
  15. Purvis RS , Tyring SK . Cutaneous and subcutaneous endometriosis. Surgical and hormonal therapy . J Dermatol Surg Oncol . 1994;20:693–695

PII: S1028-4559(09)60234-5

doi:10.1016/S1028-4559(09)60234-5

Taiwanese Journal of Obstetrics and Gynecology
Volume 45, Issue 3 , Pages 247-249, September 2006

Article Tools