An episiotomy scar site endometriosis: a rare case report and review of literature
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20221958Keywords:
Endometriosis, Surgical scar site endometriosis, Perineal scar endometriosis, Episiotomy scar endometriosisAbstract
Endometriosis can be defined as the presence and growth of functioning endometrial tissue (glands and or stroma) outside the endometrium. Occasionally, surgical scars are the sites of endometriotic implantation particularly perineal scars (episiotomy). Perineal scar endometriosis is a very rare condition, its incidence rate was about 0.03-0.15%. Perineal scar endometriosis mainly affects young females at the episiotomy site following a previous vaginal delivery. A 29 years old patient presented with swelling at the site of episiotomy which was associated with pain during menstruation. On examination a palpable mass was revealed without induration at close proximity to episiotomy scar site during menstruation. MRI pelvis is the most commonly used imaging technique for the diagnosis of perineal endometriosis as well as to assess the deeper extent of the lesion. Mass excised and sent for histopathological examination. Wide local excision is the definitive treatment for surgical site endometriosis. Follow up is recommended for recurrence. The rare possibility of malignant transformation, can be excluded by histopathological examination of excised tissue.
References
Sharma N, Khan DA, Jethani R, Baruah S, Dey B. Perineal Endometriosis in an Episiotomy scar: A Case Report and Review of Literature. Gynecol Obstet Case Rep. 2018;4(2):66
Saloum NM, Quershi S, Ibrahim SA, Alrashid A. A rare case report of endometriosis in an episiotomy scar without anal sphincter involvement. EC Gynaecol. 2018;7:466-70.
de Gauna BR, Rodriguez D, Cabre S, Callejo J. A case of endometriosis in episiotomy scar with anal sphincter involvement. Int J Clin Med. 2011;2:624-6.
Leite G, Carvalho LF, Korkes H. Scar endometrioma following obstetric surgical incisions: Retrospective study on 33 cases and review of the literature. Sao Paulo Med J. 2009;127:15-7.
Jeyaseelan S, Kwatra N. A rare case of episiotomy scar endometriosis. J Obstet Gynecol India. 2016;66:654-5.
Gauna BRD, Rodriguez D, Cabre S, Callejo J. A Case of Endometriosis in episiotomy scar with anal sphincter involvement. Int J Clin Med. 2011;2:624-6.
Goel P, Sood SS, Dalal A, Romilla. Caesarean scar endometriosis: Report of two cases. Indian J Med Sci. 2005;59:495-8.
Sharma N, Theik JL, Rituparna D, Mishra J, Singh AS. Incisional endometriosis: A rare case of painful scar. J Midwifery Reproductive Health. 2017;5:927-9.
Al-Jabri K. Endometriosis at caesarean section scar. OMJ. 2009;24:294-5.
Jain D. Perineal scar endometriosis: A comparison of two cases. BMJ Case Rep. 2013;29:1.
Andola US, Andola SK, Sanghvi KJ. FNAC diagnosis of Scar endometriosis: A report of 3 cases with review of literature. J Basic Clin Reprod Sci. 2012;1:62-4.
Kang SK, Lee MW, Choi JH, Sung KJ, Moon KC. Cutaneous endometriosis: A combination of medical and surgical treatment. J Dermatolog Treat. 2002;13:189-92.
Cinardi N, Franco S, Centonaze D, Giannone G. Perineal scar endometriosis 10 years after Miles’ procedure for rectal cancer: Case report and review of literature. Int J Surg Case Reports. 2011;2:150-3.
Medeiros FC, Calvalcante DM. Fine needle aspiration cytology of scar endometriosis: A study of seven cases and literature review. Diagnostic Cytopathology. 2011;39:189-92.
Paull T, Tedischi LG. Perineal endometriosis at the site of episiotomy scar. Obstet Gynecol. 1972;40:28-34.
