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CESAREAN SCAR ENDOMETRIOSIS: PRESENTATION OF 10 CASES AND LITERATURE REVIEW

Year 2022, , 40 - 43, 31.08.2022
https://doi.org/10.52831/kjhs.1024762

Abstract

Objective: Endometriosis, characterized by the presence of functioning endometrial tissue in non-uterine locations, is a relatively common disease in women of reproductive age (10-15%). Besides that, cesarean scar endometriosis (CSE) is rarely seen; the clinical presentation of the disease is mainly in the form of a painful mass at the cesarean incision site.
Method: Ten patients, whose diagnosis was confirmed histopathologically by surgery with CSE anterior chamber, were evaluated in terms of clinical and histopathological features.
Results: The mean age of patients was 35 (min-max:22-45). Six (75%) of patients with pain symptoms were cyclic, and 2 (25%) were noncyclic. The mean latency period (time from last cesarean section to the beginning of symptoms) was 44,6 (min-max:6-88) months, and the mean duration between symptoms and surgery was 28,9 (min-max:2-60) months. Six (60%) of endometriomas were located right corner of the incision, and 4 (40%) were at the left. All of the endometriomas were solitary. The mean hospitalization time was 2,5 (min-max:1-6) days.
Conclusion: Excision of endometriotic foci within 1 cm safety margins may be an appropriate curative treatment option.

References

  • Giudice LC, Kao LC. Endometriosis. Lancet. 2004;364(9447):1789-1799.
  • Steck WD, Helwig EB. Cutaneous endometriosis. Clin Obstet Gynecol. 1966;9(2):373-383.
  • Markham SM, Carpenter SE, Rock JA. Extrapelvic endometriosis. Obstet Gynecol Clin N Am. 1989;16(1):193-219.
  • Ideyi SC, Schein M, Niazi M, Gerst PH. Spontaneous endometriosis of the abdominal wall. Dig Surg. 2003;20(3):246-248.
  • Blanco RG, Parithivel VS, Shah AK, Gumbs MA, Schein M, Gerst PH. Abdominal wall endometriomas. Am J Surg. 2003;185(6):596-598.
  • Dwivedi AJ, Agrawal SN, Silva YJ. Abdominal wall endometriomas. Dig Dis Sci. 2002;47(2):456-461.
  • Koger KE, Shatney CH, Hodge K, McClenathan JH. Surgical scar endometrioma. Surg Gynecol Obstet. 1993;177(3):243-246.
  • Hughes ML, Bartholomew D, Paluzzi M. Abdominal wall endometriosis after amniocentesis: a case report. J Reprod Med. 1997;42(9):597-599.
  • Chang Y, Tsai EM, Long CY, Chen YH, Kay N. Abdominal wall endometriomas. J Reprod Med. 2009;54(3):155-159.
  • Vellido-Cotelo R, Muñoz-González JL, Oliver-Pérez MR, et al. Endometriosis node in gynaecologic scars: a study of 17 patients and the diagnostic considerations in clinical experience in tertiary care center. BMC Women’s Health. 2015;15:13-22.
  • Ping Zhang, Yabing Sun, Chen Zhang, et al. Cesarean scar endometriosis: presentation of 198 cases and literature review. BMC Women’s Health. 2019;19:14-19.
  • Ferrandina G, Paluzzi E, Fanfani F, et al. Endometriosis-associated clear cell carcinoma arising in cesarean section scar: a case report and review of the literature. World J Surg Oncol. 2016;14:300-307.
  • Leng J, Lang J, Guo L, Li H, Liu Z. Carcinosarcoma arising from atypical endometriosis in a cesarean section scar. Int J Gynecol Cancer. 2006;16(1):432-435.
  • Akbarzadeh-Jahromi M, Motavas M, Fazelzadeh A. Recurrent abdominal wall endometriosis at the trocar site of laparoscopy: A rare case. Int J Reprod Biomed (Yazd). 2018;16:653-656.
  • Wolf Y, Haddad R, Werbin N, Skornick Y, Kaplan O. Endometriosis in abdominal scars: a diagnostic pitfall. Am Surgeon. 1996;62(12):1042-1044.
  • Witz CA. Current concepts in the pathogenesis of endometriosis. Clin Obstet Gynecol. 1999;42(3):566-585.
  • Sumathy S, Mangalakanthi J, Purushothaman K, et al. Symptomatology and surgical perspective of scar endometriosis: a case series of 16 women. J Obstet Gynaecol India. 2017;67:218-223. 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.
  • Bumpers HL, Butler KL, Best IM. Endometrioma of the abdominal wall. Am J Obstet Gynecol. 2002;187(6):1709-1710.
  • Yıldırım D, Tatar C, Oğan O, et al. Post-cesarean scar endometriosis. Turk J Obstet Gynecol 2018;15:33-38.
  • Bektaş H, Bilsel Y, Sarı YS, et al. Abdominal wall endometrioma; a 10-year experience and brief review of the literature. J Surg Res. 2010;164:77-81.
  • Balleyguier C, Chapron C, Chopin N, He´le´non O, Menu Y. Abdominal wall and surgical scar endometriosis: results of magnetic resonance imaging. Gynecol Obstet Invest. 2003;55(4):220-224.
  • Matthes G, Zabel DD, Nastala CL, Shestak KC. Endometrioma of the abdominal wall following combined abdominoplasty and hysterectomy: case report and review of the literature. Ann Plast Surg. 1998;40(6):672-675.
  • Horton JD, Dezee KJ, Ahnfeldt EP. Abdominal wall endometriosis: a surgeon’s perspective and review of 445 cases. Am J Surg. 2008;196:207-212.
  • Biberoğlu E, Biberoğlu K. Endometriosis and pelvic pain (evidence based medicine). Turkiye Klinikleri J Gynecol Obst-Special Topics. 2010;3(3):54-61.
  • Xiao-Ying Z, Hua D, Jin-Juan W, et al. Clinical analysis of high-intensity focused ultrasound ablation for abdominal wall endometriosis: a 4-year experience at a specialty gynecological institution. Int J Hyperthermia. 2019;36:87-94.
  • Zhao L, Deng Y, Wei Q, et al. Comparison of ultrasound-55. guided high-intensity focused ultrasound ablation and surgery for abdominal wall endometriosis. Int J Hyperthermia. 2018;35:528-533.
  • Lee JS, Kim YJ, Hong GY, et al. Abdominal wall endometriosis treatment by ultrasound-guided high-intensity focused ultrasound ablation: a case report. Gynecol Endocrinol. 2019;35:109-111.

SEZARYEN SCAR ENDOMETRİOZİS: 10 OLGUNUN SUNUMU VE LİTERATÜR İNCELEMESİ

Year 2022, , 40 - 43, 31.08.2022
https://doi.org/10.52831/kjhs.1024762

Abstract

Amaç: Endometriozis, endometrial dokunun uterus dışı yerleşimlerde varlığı ile karakterize olup, üreme çağındaki kadınlarda nispeten sık görülen bir hastalıktır (%10-15). Bunun yanında sezaryen skar endometriozisi (CSE) nadiren görülür; hastalığın klinik görünümü esas olarak sezaryen insizyon hattında ağrılı bir kitle şeklindedir.
Yöntem: CSE ön tanısı ile opere edilerek tanının histopatolojik olarak doğrulandığı 10 hasta klinik ve histopatolojik özellikleri açısından değerlendirildi.
Bulgular: Hastaların yaş ortalaması 35 (min-maks:22-45) idi. Ağrı semptomları hastaların altısında (%75) siklik, 2'sinde (%25) nonsiklik karakterdeydi. Ortalama hastalığın görülme süresi (son sezaryen ile semptomların başlangıcına kadar geçen süre) 44,6 (min-maks:6-88) ay ve semptomlar ile ameliyat arasındaki ortalama süre 28,9 (min-maks:2-60) ay idi. Altı hastada (%60) endometrioma insizyonun sağ köşesinde, 4 hastada ise (%40) soldaydı. Endometriomaların tamamı soliter yapıda izlendi. Ortalama hastanede kalış süresi 2,5 (min maks:1-6) gündü.
Sonuç: Endometriotik odakların, 1 cm güvenlik sınırı ile eksizyonu uygun bir küratif tedavi seçeneği olabilir.

References

  • Giudice LC, Kao LC. Endometriosis. Lancet. 2004;364(9447):1789-1799.
  • Steck WD, Helwig EB. Cutaneous endometriosis. Clin Obstet Gynecol. 1966;9(2):373-383.
  • Markham SM, Carpenter SE, Rock JA. Extrapelvic endometriosis. Obstet Gynecol Clin N Am. 1989;16(1):193-219.
  • Ideyi SC, Schein M, Niazi M, Gerst PH. Spontaneous endometriosis of the abdominal wall. Dig Surg. 2003;20(3):246-248.
  • Blanco RG, Parithivel VS, Shah AK, Gumbs MA, Schein M, Gerst PH. Abdominal wall endometriomas. Am J Surg. 2003;185(6):596-598.
  • Dwivedi AJ, Agrawal SN, Silva YJ. Abdominal wall endometriomas. Dig Dis Sci. 2002;47(2):456-461.
  • Koger KE, Shatney CH, Hodge K, McClenathan JH. Surgical scar endometrioma. Surg Gynecol Obstet. 1993;177(3):243-246.
  • Hughes ML, Bartholomew D, Paluzzi M. Abdominal wall endometriosis after amniocentesis: a case report. J Reprod Med. 1997;42(9):597-599.
  • Chang Y, Tsai EM, Long CY, Chen YH, Kay N. Abdominal wall endometriomas. J Reprod Med. 2009;54(3):155-159.
  • Vellido-Cotelo R, Muñoz-González JL, Oliver-Pérez MR, et al. Endometriosis node in gynaecologic scars: a study of 17 patients and the diagnostic considerations in clinical experience in tertiary care center. BMC Women’s Health. 2015;15:13-22.
  • Ping Zhang, Yabing Sun, Chen Zhang, et al. Cesarean scar endometriosis: presentation of 198 cases and literature review. BMC Women’s Health. 2019;19:14-19.
  • Ferrandina G, Paluzzi E, Fanfani F, et al. Endometriosis-associated clear cell carcinoma arising in cesarean section scar: a case report and review of the literature. World J Surg Oncol. 2016;14:300-307.
  • Leng J, Lang J, Guo L, Li H, Liu Z. Carcinosarcoma arising from atypical endometriosis in a cesarean section scar. Int J Gynecol Cancer. 2006;16(1):432-435.
  • Akbarzadeh-Jahromi M, Motavas M, Fazelzadeh A. Recurrent abdominal wall endometriosis at the trocar site of laparoscopy: A rare case. Int J Reprod Biomed (Yazd). 2018;16:653-656.
  • Wolf Y, Haddad R, Werbin N, Skornick Y, Kaplan O. Endometriosis in abdominal scars: a diagnostic pitfall. Am Surgeon. 1996;62(12):1042-1044.
  • Witz CA. Current concepts in the pathogenesis of endometriosis. Clin Obstet Gynecol. 1999;42(3):566-585.
  • Sumathy S, Mangalakanthi J, Purushothaman K, et al. Symptomatology and surgical perspective of scar endometriosis: a case series of 16 women. J Obstet Gynaecol India. 2017;67:218-223. 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.
  • Bumpers HL, Butler KL, Best IM. Endometrioma of the abdominal wall. Am J Obstet Gynecol. 2002;187(6):1709-1710.
  • Yıldırım D, Tatar C, Oğan O, et al. Post-cesarean scar endometriosis. Turk J Obstet Gynecol 2018;15:33-38.
  • Bektaş H, Bilsel Y, Sarı YS, et al. Abdominal wall endometrioma; a 10-year experience and brief review of the literature. J Surg Res. 2010;164:77-81.
  • Balleyguier C, Chapron C, Chopin N, He´le´non O, Menu Y. Abdominal wall and surgical scar endometriosis: results of magnetic resonance imaging. Gynecol Obstet Invest. 2003;55(4):220-224.
  • Matthes G, Zabel DD, Nastala CL, Shestak KC. Endometrioma of the abdominal wall following combined abdominoplasty and hysterectomy: case report and review of the literature. Ann Plast Surg. 1998;40(6):672-675.
  • Horton JD, Dezee KJ, Ahnfeldt EP. Abdominal wall endometriosis: a surgeon’s perspective and review of 445 cases. Am J Surg. 2008;196:207-212.
  • Biberoğlu E, Biberoğlu K. Endometriosis and pelvic pain (evidence based medicine). Turkiye Klinikleri J Gynecol Obst-Special Topics. 2010;3(3):54-61.
  • Xiao-Ying Z, Hua D, Jin-Juan W, et al. Clinical analysis of high-intensity focused ultrasound ablation for abdominal wall endometriosis: a 4-year experience at a specialty gynecological institution. Int J Hyperthermia. 2019;36:87-94.
  • Zhao L, Deng Y, Wei Q, et al. Comparison of ultrasound-55. guided high-intensity focused ultrasound ablation and surgery for abdominal wall endometriosis. Int J Hyperthermia. 2018;35:528-533.
  • Lee JS, Kim YJ, Hong GY, et al. Abdominal wall endometriosis treatment by ultrasound-guided high-intensity focused ultrasound ablation: a case report. Gynecol Endocrinol. 2019;35:109-111.
There are 27 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Articles
Authors

Emin Levent Aksoy 0000-0002-4862-1231

Nigar Almadadova 0000-0001-9290-3650

Mehmet Sühha Bostancı 0000-0002-4776-6244

Osman Köse 0000-0001-5656-6853

Serdar Çimen This is me 0000-0002-1655-5807

Gözde Çakırsoy Çakar 0000-0001-6851-0945

Publication Date August 31, 2022
Submission Date November 17, 2021
Published in Issue Year 2022

Cite

Vancouver Aksoy EL, Almadadova N, Bostancı MS, Köse O, Çimen S, Çakırsoy Çakar G. CESAREAN SCAR ENDOMETRIOSIS: PRESENTATION OF 10 CASES AND LITERATURE REVIEW. Karya J Health Sci. 2022;3(2):40-3.