[Endometriosis implant in cesarean section surgical scar]

Abstract

Introduction: Abdominal wall endometrioma is a clinical entity characterized by presence of a tumor located somewhere inside a surgical scar, most frequently after cesarean section, although it has been described after hysterectomy or laparotomy. It is associated with episodes of periodic pain confirmed by histopathologic examination. Our objective was to describe a characteristic triad of periodic pain, tumor, and history of cesarean section in a group of patients.

Material and methods: We conducted a case series of 25 patients between January 1994 and August 2002 who presented a triad consisting of periodic pain, associated with menses, history of cesarean section, and tumor inside a surgical scar confirmed as endometrium after histopathologic exam.

Results: Patients presenting the triad were subjected to surgical resection of the tumor including skin, adipose tissue, muscle, and peritoneum. Samples revealed endometrium after histopathologic examination. Patients presented 100% recovery after surgical treatment without relapse of symptoms during follow-up to date.

Conclusions: Abdominal wall endometrioma can be identified by the triad described by Esquivel. Surgical treatment shows satisfactory results.