A case of Abdominal Wall Endometriosis at the Caesarean Section Scar

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  • Nakamura Hideharu
    Department of Plastic and Reconstructive Surgery, National Hospital Organization Takasaki General Medical Center Department of Oral and Maxillofacial Surgery, Plastic Surgery, Gunma University Graduate School of Medicine
  • Makiguchi Takaya
    Department of Oral and Maxillofacial Surgery, Plastic Surgery, Gunma University Graduate School of Medicine
  • Kobayashi Mio
    Department of Obstetrics and Gynecology, Gunma University Graduate School of Medicine
  • Aoki Daichi
    Department of Oral and Maxillofacial Surgery, Plastic Surgery, Gunma University Graduate School of Medicine
  • Hirai Yuki
    Department of Oral and Maxillofacial Surgery, Plastic Surgery, Gunma University Graduate School of Medicine
  • Yamatsu Yukie
    Department of Oral and Maxillofacial Surgery, Plastic Surgery, Gunma University Graduate School of Medicine
  • Shoda Koki
    Department of Oral and Maxillofacial Surgery, Plastic Surgery, Gunma University Graduate School of Medicine
  • Mori Yumi
    Department of Oral and Maxillofacial Surgery, Plastic Surgery, Gunma University Graduate School of Medicine
  • Sirabe Ken
    Department of General Surgical Science, Gunma University Graduate School of Medicine
  • Iwase Akira
    Department of Obstetrics and Gynecology, Gunma University Graduate School of Medicine
  • Yokoo Satoshi
    Department of Oral and Maxillofacial Surgery, Plastic Surgery, Gunma University Graduate School of Medicine

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Other Title
  • 帝王切開手術瘢痕に生じた腹壁子宮内膜症の1例
  • テイオウ セッカイ シュジュツハンコン ニ ショウジタ フクヘキ シキュウ ナイマクショウ ノ 1レイ

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Abstract

<p>　　We experienced a case of abdominal wall endometriosis (AWE) that arised from the caesarean section scar. The patient was a woman in her 40s. She visited our hospital for an abdominal wall mass accompanied by periodically pain that was noticed half a year previously. She had undergone a caesarean section 2 years ago, and had a subcutaneous tumor of 2 cm in size on the cranial edge of the scar. Ultrasonography revealed a heterogeneous hypoechoic mass on the anterior layer of the rectus sheath, and magnetic resonance imaging revealed a nodule with a low signal intensity on T1-weighted imaging and mild high signal intensity on T2-weighted imaging. We suspected AWE, and she underwent tumor resection under general anesthesia. A histopathological examination revealed endometrial glands and stroma in the tissues, confirming the diagnosis of AWE. AWE is expected to increase due to an increase in the number of caesarean sections performed worldwide. We should consider AWE as a differential diagnosis in women with subcutaneous tumors associated with menstrual cyclic pain or swelling in the incisional scar after caesarean section and other abdominal surgery.</p>

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