DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20200912

A rare case of perineal endometriosis with anal sphincter involvement

Bhadana Priyanka, Abha Kiran, Veena Ganju Malla

Abstract


Perineal endometriosis is a rare entity which can be explained by direct implantation of endometriotic cells over the fresh episiotomy wound and subsequent development of scar endometriosis. Perineal scar endometriosis incidence is reported to be 0.3% to 1%. 28 years old, P1L1, presented with pain and swelling near episiotomy site which is associated with menstruation. Examination during menstruation revealed swelling was tender, erythematous and slightly increased in size. Clinical diagnosis of scar endometriosis was made after clinical examination. Mass excised and sent for histopathological examination. Although diagnosis essentially remains clinical, preoperative evaluation with perineal ultrasound and MRI was performed. Wide local excision remains treatment of choice and follow up for recurrence is recommended. Histopathological examination is obligatory to exclude rare possibility of malignant changes.


Keywords


Dyspareunia, Dysmenorroea, Endometriosis, Perineal endometriosis, Scar endometriosis, Wide local excision

Full Text:

PDF

References


Gauna BRD, Rodriguez D, Cabre S, Callejo J. A Case of Endometriosis in episiotomy scar with anal sphincter involvement. Inter J Clin Med. 2011;2:624-6.

Al-Jabri K. Endometriosis at caesarian section scar. OMJ. 2009;24:294-5.

Laadioui M, Alaoui F, Jayi S, Bouguern H, Chaara H. L’endometriose perineale profonde surcicatriced’episiotomie: A propos d’un cas rare. Pan African Med J. 2013;16:112.

Vinatier D, Orazi G, Cosson M, Dufour P. Theories of endometriosis. European Journal of Obstet Gynecol Reprod Biol. 2001;96(1):21-34.

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.

Schoelefield HJ, Sajjad Y, Morgan PR (2002) Cutaneous endometriosis and its association with caesarean section and gynaecological procedures. J Obstet Gynaecol. 2002;22:553-4.

Medeiros FC, Calvalcante DM. Fine needle aspiration cytology of scar endometriosis: A study of seven cases and literature review. Diagnos Cytopathol. 2011;39:18-21.

Demir M, Yildiz A, Ocal I, Yetimalar MH, Kilic D. Endometriosis in episiotomy scar: A case report. J Cases Obstet Gynecol. 2014;1:8-10.

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.

Hitti IF, Glasberg SS, Lubicz S. Clear cell carcinoma arising in extraovarian endometriosis: Report of three cases and review of the literature. Gynecol Oncol. 1990;39:314-20.

Jain D. Perineal scar endometriosis: a comparison of two cases. BMJ Case Rep. 2013;29:1.