Abdominal Wall Endometrioma: A Diagnostic Enigma—A Case Report and Review of the Literature (original) (raw)
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Case Reoprts in Obstetrics and Gynaecology, 2019
Background. Abdominal wall endometriomas are quite uncommon. They are usually misdiagnosed by both the surgeon and the gynaecologist. Awareness of the details of this rare condition is therefore essential for prompt diagnosis and adequate treatment. Introduction. Endometriosis though a condition commonly seen in the pelvic region can also occur at extrapelvic sites giving rise to a diagnostic dilemma. Abdominal wall endometrioma is one such complex variant of extrapelvic endometriosis with an incidence of less than 2% following gynaecologic operations. Case Report. A case of abdominal wall endometrioma diagnosed clinically and treated by wide surgical resection is presented to highlight the importance of clinical evaluation in the diagnosis of this condition. Discussion. The etiopathogenesis, presentation, investigations, and management are discussed briefly. Conclusion. Clinical evaluation confirmed by supportive imaging is diagnostic. Wide local excision is the mainstay of treatment.
Abdominal Wall Endometrioma: A Case Report and Review of the Literature
AORN Journal, 2010
Endometriosis is the presence of ectopic endometrial tissue that can respond to ovarian hormonal stimulation. Although it is uncommon, extrapelvic endometriosis can form a discrete mass known as an abdominal wall endometrioma. Endometriomas are thought to be caused by transfer of endometrial cells into a surgical wound, most often after a cesarean delivery. Endometriomas are diagnosed via ultrasound, computed tomography, magnetic resonance imaging, and ultrasound-guided fine needle aspiration. Treatment options can be medical, but surgical excision is the treatment of choice. Perioperative nursing care includes patient teaching, taking steps to prevent surgical site infection and inadvertent hypothermia, ensuring availability of supplies (eg, the graft for abdominal wall repair if needed), and postoperative pain management. AORN J 91 (June 2010) 730-742. © AORN, Inc, 2010.
Abdominal wall endometriosis: a surgeon's perspective and review of 445 cases
The American Journal of Surgery, 2008
BACKGROUND: Abdominal wall endometriosis (AWE) is defined as endometrial tissue superficial to the peritoneum. AWE often is misdiagnosed and referred to surgeons for treatment. We performed a systematic review of published cohorts to quantify demographics, symptoms, and outcomes of patients having AWE. METHODS: An English language PubMed search from January 1951 to August of 2006 was conducted using several search terms for endometrioma. CONCLUSIONS: Twenty-nine articles describing 455 patients were identified and met inclusion criteria. The pooled mean age was 31.4 years. Ninety-six percent presented with a mass, 87% presented with pain, and 57% presented with cyclic symptoms. AWE was associated with a caesarian scar or hysterectomy in 57% and 11% of cases, respectively. The interval from index surgery to presentation was 3.6 years. Recurrence after resection was 4.3%. The most common presentation of AWE is the development of a painful mass after uterine surgery. Surgical treatment appears to result in a cure more than 95% of the time.
Anterior abdominal wall endometrioma: a diagnostic dilemma
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
The presence of functioning endometrium outside the uterine cavity is often encountered in gynaecological practice but an extremely rare entity is its extra pelvic variant is seen sometimes around the umbilicus, anterior rectus sheath vesical region, also rarely seen around the kidney’s nasal mucosa, lungs and the pleura. The incidence of this condition is as low as 0.03% to 0.15%. Endometrioma of the anterior rectus sheath is well documented in literature but because of its rarity may pose a diagnostic dilemma. Reporting herewith a case of anterior rectus sheath endometrioma where medical line of treatment failed and surgical excision was required.
Abdominal Wall Endometriosis: A Diagnostic Dilemma for Surgeons
Medical Principles and Practice, 2005
were discharged from hospital on either the 2nd or the 3rd postoperative day uneventfully, and during followup there were no signs of pelvic endometriosis, as confi rmed by ultrasonography, CA 125 measurement, gynecological consultation and examination. Conclusion: Since the diagnosis of scar endometrioma is rarely established prior to surgery, endometriosis should be included in the differential diagnosis of masses on the abdominal wall.
International Journal of Gynecology & Obstetrics, 2005
Objective: To investigate the clinical characteristics, treatment, and factors of recurrence of abdominal wall endometriomas (AWE). Method: Sixty-four cases of AWE diagnosed at Peking Union Medical College Hospital (PUMCH) from 1983 to 2003 were reviewed retrospectively. Result: There was an AWE incidence of 0.044% among the parturients undergoing cesarean section at PUMCH, of whom 87.5% had the typical complaint of an enlarging mass and pain during menstruation. Among these women, 62 underwent low abdominal surgery for endometrioma (2 for primary umbilicus endometrioma); 2 women with small endometriomas opted for a temporary medical solution and had relief after menopause. The latent period of AWE positively correlated to the women's age at onset of symptoms (P b 0.001). Of the 62 women who underwent local excision, 19 had an unsatisfactory experience with medical management. There were 5 recurrences and 1 evolution to malignancy during a mean follow-up of 83.7 months. Recurrence was closely related to the size and depth of lesions. Conclusion: Because of its typical clinical manifestations, abdominal wall endometriomas could be diagnosed before pregnancy. Surgical excision is the only effective treatment and wide local excision with clear margins is the key point to prevent recurrence.
Bosnian journal of basic medical sciences, 2017
Abdominal wall endometriosis (AWE) is a rare form of endometriosis that usually develops in the scar after cesarean section (CS). Recently, the occurrence of AWE has been increasing together with the increase of CS incidence. AWE can be clinically misdiagnosed as hernia, lipoma, or hematoma. Here we retrospectively analyzed the clinical aspects of AWE and surgical approach in 14 patients from a tertiary hospital, who were treated by surgery, between 2012 and 2017. The mean age was 32.71 ± 8.61 years (range: 19-45). Palpable mass and cyclic pain at the scar site were the most common complaints. Twelve patients had previously undergone CS, and two patients had undergone a surgery of ovarian endometrioma. The preoperative diagnosis was determined with ultrasonography (US), magnetic resonance imaging (MRI), or computed tomography (CT). Preoperatively, AWE was diagnosed in 12/14 patients (85.7%), while two patients (14.3%) were diagnosed with inguinal hernia. The treatment was surgical e...
Abdominal wall endometriosis; A Case Report
2010
Abdominal wall endometriosis has an incidence of 0.3-1% of extrapelvic disease. A 48-year-old female appeared in the emergency department with cellulitis in a lower midline incision. She had an endometrioma of the anterior abdominal wall removed 2 years ago. After 5 months, she underwent an open repair of an incisional hernia with a propylene mesh, which was unfortunately infected and removed 1 month later. Finally, in July 2019, she had her incisional hernia repaired with a biological mesh. Imaging modalities revealed a large mass below the umbilicus. Mass was punctured under ultrasound guidance. Cytology reported the recurrence of endometriosis. Pain and abdominal mass associating with menses were the two most typical symptoms. Wide local excision of the mass with at least 1 cm negative margins is the preferred treatment. Surgeons should maintain a high suspicion of the disease in reproductive women with circular pain, palpable abdominal mass and history of uterine-relating surgery.
[Abdominal wall endometriosis: case report]
Revista de la Facultad de Ciencias Médicas (Córdoba, Argentina), 2004
Endometriosis is defined as the presence of endometrial glands and stroma outside uterus. This ectopic finding occur in the abdominal wall among 0,03% to 1% of women with prior gynecologic surgery, particularly after cesarean section. Most frequently, endometriosis is present as a palpable mass, painfull during menstrual period, near surgical scar. It could mimic other pathologies such as hematomas, granulomas, inicisional hernias, abscesses and tumors. We report the case of a 35 years old woman with a painful mass during menstruation nearly cesarean scar. The tumor was completely removed and a polipropylen mesh was placed to repair the abdominal wall defect. It was identified as endometriosis in the anatomo-patologic examination.