A classic case of caesarean scar endometriosis in 39-year-old women presenting with cyclical abdominal pain: a case report

Hanswahini Garg; Anup Pradhan

doi:10.18203/2320-1770.ijrcog20262576

Authors

Hanswahini Garg Department of Obstetrics and Gynaecology, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Gangtok, Sikkim, India
Anup Pradhan Department of Obstetrics and Gynaecology, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Gangtok, Sikkim, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20262576

Keywords:

Scar endometriosis, Abdominal wall mass, Caesarean section, Surgical scar, Ectopic endometrial tissue, Cyclical abdominal pain, FNAC, Abdominal or pelvic surgery

Abstract

Scar or incisional scar endometriosis is a rare but increasingly recognised complication following obstetric and gynaecological surgeries, particularly caesarean section and others, including hysterectomy and myomectomy. It is frequently misdiagnosed due to its nonspecific presentation, which often mimics abscesses, hernias, hematomas, granulomas or neoplasms. This case report outlines a case of a female aged 39 years who reported with complaints of abdominal pain related to the menstrual cycles and a palpable infra-umbilical mass years after caesarean delivery. Ultrasonography revealed a hypoechoic solid lesion with internal vascularity, and fine needle aspiration cytology was suggestive of scar endometriosis. The patient underwent complete surgical excision, and histopathology confirmed the diagnosis. The case highlights the importance of clinical suspicion when a patient presents with the classical triad, appropriate imaging, and histopathological confirmation in diagnosing scar endometriosis. Surgical excision remains the definitive treatment.

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