Scar endometriosis

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Presented with 2 years history of dysmenorrhea. Previous Cesarean section 7 years previously.

Patient Data

Age: 30 years
Gender: Female
ultrasound

There is an irregular, infra-umbilical, anterior abdominal wall lesion (19 x 15 x 11 mm) in relation to previous lower section Cesarean section scar. It is in the deeper part of thesubcutaneous fat plane; abutting the anterior surface of rectus abdominis. The lesion is hypoechoic without calcification / cystic changes. The lesion is not compressible. There are few flow signals in the peripheral part of the lesion. 

Case Discussion

Patient with a previous Cesarean section presented with dysmenorrhea. Ultrasound shows an anterior abdominal wall lesion in the vicinity of her Cesarean section scar. Ultrasound findings in combination with her clinical background favor scar endometriosis.

Surgical excision of the lesion was carried out. Histopathology revealed scar endometriosis. Free margins were noted in histopathology sample.

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