Case Report
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Abdominal Wall Endometriosis: A Case Report

Year 2025, Volume: 11 Issue: 1, 87 - 95, 28.02.2025

Abstract

Abdominal wall endometriosis is the development of endometrial tissue on the anterior abdominal wall, usually secondary to an operation in which the uterus is manipulated or its integrity is disrupted, usually by cesarean section. In this article, we planned to present the presentation, clinical investigation and surgical treatment of a case of abdominal wall endometriosis. A 29-year-old female patient applied to the outpatient clinic with abdominal pain that became apparent during the menstrual cycle at the location of a previous cesarean scar. During the examination of the patient, a mass suspected to be composed of endometrial tissue was observed on the abdominal wall. The indicated tissue was excised during surgery and after histological analysis, endometrial tissue due to a previous cesarean section was pathologically confirmed. In conclusion, although rare, endometriosis should be considered in the differential diagnosis if a painful mass is found in the scar area of a Pfannenstiel incision or a similar incision in women in the reproductive period with a history of obstetric surgery.

References

  • Ail DA, Joshi AR, Manzoor I, Patil S, Kulkarni M. Fine-needle Aspiration Cytology of Abdominal Wall Endometriosis: 
A Meaningful Adjunct to Diagnosis. Oman Med J. 2018;33(1):72-75. doi:10.5001/omj.2018.14
  • Alaert J, Lancelle M, Timmermans M, Tanos P, Nisolle M, Karampelas S. Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review. Journal of Clinical Medicine. 2024; 13(8):2282. https://doi.org/10.3390/jcm13082282
  • Burney RO, Giudice LC. Pathogenesis and pathophysiology of endometriosis. Fertil Steril. 2012;98(3):511-519. doi:10.1016/j.fertnstert.2012.06.029
  • Doroftei B, Armeanu T, Maftei R, Ilie OD, Dabuleanu AM, Condac C. Abdominal Wall Endometriosis: Two Case Reports and Literature Review. Medicina (Kaunas). 2020;56(12):727. Published 2020 Dec 21. doi:10.3390/medicina56120727
  • Emre A, Akbulut S, Yilmaz M, Bozdag Z. Laparoscopic trocar port site endometriosis: a case report and brief literature review. Int Surg. 2012;97(2):135-139. doi:10.9738/CC124.1
  • Gidwaney R, Badler RL, Yam BL, et al. Endometriosis of abdominal and pelvic wall scars: multimodality imaging findings, pathologic correlation, and radiologic mimics. Radiographics. 2012;32(7):2031-2043. doi:10.1148/rg.327125024
  • Guerriero S, Condous G, van den Bosch T, et al. Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group. Ultrasound Obstet Gynecol. 2016;48(3):318-332. doi:10.1002/uog.15955
  • Hasan A, Deyab A, Monazea K, et al. Clinico-pathological assessment of surgically removed abdominal wall endometriomas following cesarean section. Ann Med Surg (Lond). 2021;62:219-224. Published 2021 Jan 21. doi:10.1016/j.amsu.2021.01.029
  • Hensen JH, Van Breda Vriesman AC, Puylaert JB. Abdominal wall endometriosis: clinical presentation and imaging features with emphasis on sonography. AJR Am J Roentgenol. 2006;186(3):616-620. doi:10.2214/AJR.04.1619
  • Horne AW, Missmer SA. Pathophysiology, diagnosis, and management of endometriosis. BMJ. 2022;379:e070750. Published 2022 Nov 14. doi:10.1136/bmj-2022-070750
  • Horton JD, Dezee KJ, Ahnfeldt EP, Wagner M. Abdominal wall endometriosis: a surgeon's perspective and review of 445 cases. Am J Surg. 2008;196(2):207-212. doi:10.1016/j.amjsurg.2007.07.035
  • Kesici U, Yenisolak A, Kesici S, Siviloglu C. Primary cutaneous umbilical endometriosis. Med Arch. 2012;66(5):353-354. doi:10.5455/medarh.2012.66.353-354
  • Kiesel L, Sourouni M. Diagnosis of endometriosis in the 21st century. Climacteric. 2019;22(3):296-302. doi:10.1080/13697137.2019.1578743
  • Konrad L, Dietze R, Kudipudi PK, Horné F, Meinhold-Heerlein I. Endometriosis in MRKH cases as a proof for the coelomic metaplasia hypothesis?. Reproduction. 2019;158(2):R41-R47. doi:10.1530/REP-19-0106
  • Madsen H, Hansen P, Andersen OP. Endometrioid carcinoma in an operation scar. Acta Obstet Gynecol Scand. 1980;59(5):475-476. doi:10.3109/00016348009155433
  • Rossi HR, Uimari O, Terho A, Pesonen P, Koivurova S, Piltonen T. Increased overall morbidity in women with endometriosis: a population-based follow-up study until age 50. Fertil Steril. 2023;119(1):89-98. doi:10.1016/j.fertnstert.2022.09.361
  • Shafrir AL, Farland LV, Shah DK, et al. Risk for and consequences of endometriosis: A critical epidemiologic review. Best Pract Res Clin Obstet Gynaecol. 2018;51:1-15. doi:10.1016/j.bpobgyn.2018.06.001
  • Smolarz B, Szyłło K, Romanowicz H. Endometriosis: Epidemiology, Classification, Pathogenesis, Treatment and Genetics (Review of Literature). Int J Mol Sci. 2021;22(19):10554. Published 2021 Sep 29. doi:10.3390/ijms221910554
  • Thanasa A, Thanasa E, Antoniou IR, et al. Abdominal Wall Endometriosis: Early Diagnosis of a Rare Iatrogenic Complication Following Cesarean Section. Cureus. 2024;16(3):e56284. Published 2024 Mar 16. doi:10.7759/cureus.56284
  • Vannuccini S, Clemenza S, Rossi M, Petraglia F. Hormonal treatments for endometriosis: The endocrine background. Rev Endocr Metab Disord. 2022;23(3):333-355. doi:10.1007/s11154-021-09666-w
  • Zhang P, Sun Y, Zhang C, et al. Cesarean scar endometriosis: presentation of 198 cases and literature review. BMC Womens Health. 2019;19(1):14. Published 2019 Jan 18. doi:10.1186/s12905-019-0711-8
  • Zondervan KT, Becker CM, Koga K, Missmer SA, Taylor RN, Viganò P. Endometriosis. Nat Rev Dis Primers. 2018;4(1):9. Published 2018 Jul 19. doi:10.1038/s41572-018-0008-5
  • Montgomery GW, Mortlock S, Giudice LC. Should Genetics Now Be Considered the Pre-eminent Etiologic Factor in Endometriosis?. J Minim Invasive Gynecol. 2020;27(2):280-286. doi:10.1016/j.jmig.2019.10.020

Karın Duvarı Endometriozisi: Olgu Sunumu

Year 2025, Volume: 11 Issue: 1, 87 - 95, 28.02.2025

Abstract

Karın duvarı endometriozisi, genellikle uterusun manipüle edildiği veya çoğunlukla sezaryen gibi bütünlüğünün bozulduğu bir operasyona sekonder karın ön duvarında endometrial doku gelişimidir. Bu yazıda bir karın duvarı endometriozisi vakasının sunumunu, klinik araştırmasını ve cerrahi tedavisini sunmayı planlanladık. 29 yaşında kadın hasta, geçirilmiş bir sezaryen skarının bulunduğu yerde belirginleşen menstrüel siklus döneminde belirgin hale gelen karın ağrısı ile polikliniğe başvurdu. Hastanın incelenmesi sırasında karın duvarında endometrial dokudan oluştuğundan şüphelenilen kitle görüldü. Belirtilen doku ameliyatta eksize edildi ve histolojik analizden sonra önceki sezaryene bağlı endometrial doku patolojik olarak doğrulandı. Sonuç olarak, nadir görülmekle birlikte, obstetrik cerrahi öyküsü olan reprodüktif dönemdeki kadınlarda Pfannenstiel insizyonu veya benzer bir insizyonun skar bölgesinde ağrılı bir kitle bulunursa, ayırıcı tanıda endometriozis düşünülmelidir.

References

  • Ail DA, Joshi AR, Manzoor I, Patil S, Kulkarni M. Fine-needle Aspiration Cytology of Abdominal Wall Endometriosis: 
A Meaningful Adjunct to Diagnosis. Oman Med J. 2018;33(1):72-75. doi:10.5001/omj.2018.14
  • Alaert J, Lancelle M, Timmermans M, Tanos P, Nisolle M, Karampelas S. Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review. Journal of Clinical Medicine. 2024; 13(8):2282. https://doi.org/10.3390/jcm13082282
  • Burney RO, Giudice LC. Pathogenesis and pathophysiology of endometriosis. Fertil Steril. 2012;98(3):511-519. doi:10.1016/j.fertnstert.2012.06.029
  • Doroftei B, Armeanu T, Maftei R, Ilie OD, Dabuleanu AM, Condac C. Abdominal Wall Endometriosis: Two Case Reports and Literature Review. Medicina (Kaunas). 2020;56(12):727. Published 2020 Dec 21. doi:10.3390/medicina56120727
  • Emre A, Akbulut S, Yilmaz M, Bozdag Z. Laparoscopic trocar port site endometriosis: a case report and brief literature review. Int Surg. 2012;97(2):135-139. doi:10.9738/CC124.1
  • Gidwaney R, Badler RL, Yam BL, et al. Endometriosis of abdominal and pelvic wall scars: multimodality imaging findings, pathologic correlation, and radiologic mimics. Radiographics. 2012;32(7):2031-2043. doi:10.1148/rg.327125024
  • Guerriero S, Condous G, van den Bosch T, et al. Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group. Ultrasound Obstet Gynecol. 2016;48(3):318-332. doi:10.1002/uog.15955
  • Hasan A, Deyab A, Monazea K, et al. Clinico-pathological assessment of surgically removed abdominal wall endometriomas following cesarean section. Ann Med Surg (Lond). 2021;62:219-224. Published 2021 Jan 21. doi:10.1016/j.amsu.2021.01.029
  • Hensen JH, Van Breda Vriesman AC, Puylaert JB. Abdominal wall endometriosis: clinical presentation and imaging features with emphasis on sonography. AJR Am J Roentgenol. 2006;186(3):616-620. doi:10.2214/AJR.04.1619
  • Horne AW, Missmer SA. Pathophysiology, diagnosis, and management of endometriosis. BMJ. 2022;379:e070750. Published 2022 Nov 14. doi:10.1136/bmj-2022-070750
  • Horton JD, Dezee KJ, Ahnfeldt EP, Wagner M. Abdominal wall endometriosis: a surgeon's perspective and review of 445 cases. Am J Surg. 2008;196(2):207-212. doi:10.1016/j.amjsurg.2007.07.035
  • Kesici U, Yenisolak A, Kesici S, Siviloglu C. Primary cutaneous umbilical endometriosis. Med Arch. 2012;66(5):353-354. doi:10.5455/medarh.2012.66.353-354
  • Kiesel L, Sourouni M. Diagnosis of endometriosis in the 21st century. Climacteric. 2019;22(3):296-302. doi:10.1080/13697137.2019.1578743
  • Konrad L, Dietze R, Kudipudi PK, Horné F, Meinhold-Heerlein I. Endometriosis in MRKH cases as a proof for the coelomic metaplasia hypothesis?. Reproduction. 2019;158(2):R41-R47. doi:10.1530/REP-19-0106
  • Madsen H, Hansen P, Andersen OP. Endometrioid carcinoma in an operation scar. Acta Obstet Gynecol Scand. 1980;59(5):475-476. doi:10.3109/00016348009155433
  • Rossi HR, Uimari O, Terho A, Pesonen P, Koivurova S, Piltonen T. Increased overall morbidity in women with endometriosis: a population-based follow-up study until age 50. Fertil Steril. 2023;119(1):89-98. doi:10.1016/j.fertnstert.2022.09.361
  • Shafrir AL, Farland LV, Shah DK, et al. Risk for and consequences of endometriosis: A critical epidemiologic review. Best Pract Res Clin Obstet Gynaecol. 2018;51:1-15. doi:10.1016/j.bpobgyn.2018.06.001
  • Smolarz B, Szyłło K, Romanowicz H. Endometriosis: Epidemiology, Classification, Pathogenesis, Treatment and Genetics (Review of Literature). Int J Mol Sci. 2021;22(19):10554. Published 2021 Sep 29. doi:10.3390/ijms221910554
  • Thanasa A, Thanasa E, Antoniou IR, et al. Abdominal Wall Endometriosis: Early Diagnosis of a Rare Iatrogenic Complication Following Cesarean Section. Cureus. 2024;16(3):e56284. Published 2024 Mar 16. doi:10.7759/cureus.56284
  • Vannuccini S, Clemenza S, Rossi M, Petraglia F. Hormonal treatments for endometriosis: The endocrine background. Rev Endocr Metab Disord. 2022;23(3):333-355. doi:10.1007/s11154-021-09666-w
  • Zhang P, Sun Y, Zhang C, et al. Cesarean scar endometriosis: presentation of 198 cases and literature review. BMC Womens Health. 2019;19(1):14. Published 2019 Jan 18. doi:10.1186/s12905-019-0711-8
  • Zondervan KT, Becker CM, Koga K, Missmer SA, Taylor RN, Viganò P. Endometriosis. Nat Rev Dis Primers. 2018;4(1):9. Published 2018 Jul 19. doi:10.1038/s41572-018-0008-5
  • Montgomery GW, Mortlock S, Giudice LC. Should Genetics Now Be Considered the Pre-eminent Etiologic Factor in Endometriosis?. J Minim Invasive Gynecol. 2020;27(2):280-286. doi:10.1016/j.jmig.2019.10.020
There are 23 citations in total.

Details

Primary Language Turkish
Subjects Medical Education
Journal Section Olgu Sunumu
Authors

Yahya Kaan Karatepe 0000-0003-1225-684X

Publication Date February 28, 2025
Submission Date July 25, 2024
Acceptance Date February 24, 2025
Published in Issue Year 2025 Volume: 11 Issue: 1

Cite

APA Karatepe, Y. K. (2025). Karın Duvarı Endometriozisi: Olgu Sunumu. Aydın Sağlık Dergisi, 11(1), 87-95.

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