CESAREAN SCAR ENDOMETRIOSIS: PRESENTATION OF 10 CASES AND LITERATURE REVIEW
Yıl 2022,
Cilt: 3 Sayı: 2, 40 - 43, 31.08.2022
Emin Levent Aksoy
,
Nigar Almadadova
,
Mehmet Sühha Bostancı
,
Osman Köse
,
Serdar Çimen
Gözde Çakırsoy Çakar
Öz
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.
Kaynakça
- 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
Yıl 2022,
Cilt: 3 Sayı: 2, 40 - 43, 31.08.2022
Emin Levent Aksoy
,
Nigar Almadadova
,
Mehmet Sühha Bostancı
,
Osman Köse
,
Serdar Çimen
Gözde Çakırsoy Çakar
Öz
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.
Kaynakça
- 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.