A case series of scar endometriosis: a mysterious painful scar

Authors

  • Aswenee Bhavani Institute of Social Obstetrics, Kasturba Gandhi Hospital for Women and Children, Chennai, Tamil Nadu, India
  • Nalina Sadasivam Institute of Social Obstetrics, Kasturba Gandhi Hospital for Women and Children, Chennai, Tamil Nadu, India
  • Meena Mahalingam Chengalpattu Medical College Hospital, Chennai, Tamil Nadu, India
  • Meena T. Sundarraj Institute of Social Obstetrics, Kasturba Gandhi Hospital for Women and Children, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20253100

Keywords:

Caesarean section, Endometriosis, Wide local excision

Abstract

Endometriosis is the presence of endometrial tissue outside the uterine cavity. Scar endometriosis, one of its rare variants, is the study of interest since most of the patients present to the general surgeon rather than to a gynaecologist due to its quite often non-specific symptoms. In this case series of 5 patients, 2 of the patients had presented to the general surgery department, one presented with non-specific symptom. Prior history of any obstetric (caesarean section in particular) and gynaecological surgeries must be elicited which may help in clinching towards the diagnosis. This report is about a case series of 5 patients who had variable presentations and were offered wide local excision. Diagnosis was confirmed with post-operative histopathology. The pathogenesis, treatment and prevention have been discussed.

Metrics

Metrics Loading ...

References

Singh S, Dharwadkar M. Case series of scar endometriosis- post caeserean section: A diagnostic pitfall. Indian J Obstet Gynecol Res. 2021;8(4):454-6 DOI: https://doi.org/10.18231/j.ijogr.2021.095

Bansal K. Manual of endometriosis. JP Medical Ltd. 2013.

Francica G, Giardiello C, Angelone G, Cristiano S, Finelli R, Tramontano G. Abdominal wall endometriosis near cesarean delivery scars. J Ultrasound Med. 2003;22:1041–7.

Kaloo P, Reid G, Wong F. Caesarean section scar endometriosis: Two cases of recurrent disease and a literature review. Aust NZ J Obstet Gynaecol. 2002;42:218–20. DOI: https://doi.org/10.1111/j.0004-8666.2002.210_5.x

J Danielpour P, C Layke Do J, Durie N, T Glickman L. Scar endometriosis–a rare cause for a painful scar: A case report and review of the literature. Canadian J Plast Surg. 2010;18(1):19-20. DOI: https://doi.org/10.1177/229255031001800110

Sasson IE, Taylor HS. Stem cells and the pathogenesis of endometriosis. Ann New York Acad Sci. 2008;1127(1):106-15. DOI: https://doi.org/10.1196/annals.1434.014

Nondecidualized and decidualized endometriosis of the abdominal wall (A report of two cases secondary to cesarean section) Turk J Med Sci. 2002;32:505-8.

Mathur S, Peress HO, Williamson CD, Youmans SA, Maney AJ. Autoimmunity to endometrium and ovary in endometriosis. Clin Exp Immunol. 1982;50(2):259.

Wang PH, Juang CM, Chao HT, Yu KJ, Yuan CC, Ng HT. Wound endometriosis: risk factor evaluation and treatment. J Chinese Med Assoc. 2003;66(2):113-9.

Wicherek L, Klimek M, Skret-Magierlo J, Czekierdowski A, Banas T, Popiela TJ, et al. The obstetrical history in patients with Pfannenstiel scar endometriomas–an analysis of 81 patients. Gynecol Obstet Invest. 2007;63(2):107-13. DOI: https://doi.org/10.1159/000096083

Paşalega M, Mirea C, Vîlcea ID, Vasile I, Pleşea IE, Calotă F, et al. Parietal abdominal endometriosis following Cesarean section. Rom J Morphol Embryol. 2011;52(1):503-8.

Goel P, Devi L, Tandon R, Saha PK, Dalal A. Scar endometriosis–a series of six patients. International J Surg. 2011;9(1):39-40. DOI: https://doi.org/10.1016/j.ijsu.2010.08.003

Gupta RK. Fine‐needle aspiration cytodiagnosis of endometriosis in cesarean section scar and rectus sheath mass lesions—A study of seven cases. Diagnostic Cytopathol. 2008;36(4):224-6. DOI: https://doi.org/10.1002/dc.20797

Francica G, Giardiello C, Angelone G, Cristiano S, Finelli R, Tramontano G. Abdominal wall endometriomas near cesarean delivery scars: sonographic and color doppler findings in a series of 12 patients. J Ultras Med. 2003;22(10):1041-7. DOI: https://doi.org/10.7863/jum.2003.22.10.1041

Savelli L, Manuzzi L, Di Donato N, Salfi N, Trivella G, Ceccaroni M. Endometriosis of the abdominal wall: ultrasonographic and Doppler characteristics. Ultras Obst Gynecol. 2012;39(3):336-40. DOI: https://doi.org/10.1002/uog.10052

Blanco RG, Parithivel VS, Shah AK, Gumbs MA, Schein M, Gerst PH. Abdominal wall endometriomas. The American J Surg. 2003;185(6):596-8. DOI: https://doi.org/10.1016/S0002-9610(03)00072-2

Marras S, Pluchino N, Petignat P, Wenger JM, Ris F, Buchs NC, Dubuisson J. Abdominal wall endometriosis: An 11-year retrospective observational cohort study. European J Obst Gynecol Reprod Bio. 2019;4:100096. DOI: https://doi.org/10.1016/j.eurox.2019.100096

Rivlin ME, Das SK, Patel RB, Meeks GR. Leuprolide acetate in the management of cesarean scar endometriosis. Obstet Gynecol. 1995;85(5):838-9. DOI: https://doi.org/10.1016/0029-7844(94)00270-N

Wang SK, Lee MW, Choi JH, Sung KJ, Moon KC, Koh JK. Cutaneous endometriosis: a combination of medical and surgical treatment. J Dermatol Treat. 2002;13(4):189-92. DOI: https://doi.org/10.1080/09546630212345677

Wasfie T, Gomez E, Seon S, Zado B. Abdominal wall endometrioma after cesarean section: a preventable complication. Int Surg. 2002;87(3):175-7.

Nigam A, Saxena P, Barla J, Pathak P. Scar endometriosis: the menace of surgery. BMJ Case Rep. 2014;15;2014. DOI: https://doi.org/10.1136/bcr-2014-206693

Picod G, Boulanger L, Bounoua F, Leduc F, Duval G. Abdominal wall endometriosis after caesarean section: report of fifteen cases. Gynecol Obstetr Fert. 2006;34(1):8-13. DOI: https://doi.org/10.1016/j.gyobfe.2005.11.002

Minaglia S, Ballard A. “Incisional endometriomas after cesarean section: a case series. J Reprod Med 2007;52(7):630-4.

Downloads

Published

2025-09-26

How to Cite

Bhavani, A., Sadasivam, N., Mahalingam, M., & Sundarraj, M. T. (2025). A case series of scar endometriosis: a mysterious painful scar. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 14(10), 3511–3515. https://doi.org/10.18203/2320-1770.ijrcog20253100

Issue

Section

Case Series