Cutaneous and subcutaneous endometriosis. Surgical and hormonal therapy.
BACKGROUND
Cutaneous or subcutaneous endometriosis is a rare entity that should be suspected in any female presenting with cyclic pain emanating from a mass in the vicinity of an abdominal surgical scar or the umbilicus.


OBJECTIVE
The purpose of this report is to examine the diagnostic procedures for endometriosis and to review the therapeutic value of surgical excision alone or in combination with hormonal treatment.


METHODS
Endometriosis presenting cutaneously in an infraumbilical laparoscopy scar and endometriosis occurring subcutaneously in a cesarean section scar were both diagnosed via incisional biopsy. Both lesions were treated with hormonal therapy followed by surgical excision.


RESULTS
Hormonal therapy with danazol or with leuprolide resulted in reduction of symptoms but was associated with amenorrhea in both cases and with dyspareunia in the second patient. Subsequent laparoscopy and surgical excision of the endometrioma were curative.


CONCLUSIONS
Preoperative hormonal therapy, although sometimes associated with such side effects as amenorrhea, may be used in cases of large endometriotic masses to reduce the size of the surgical defect, but surgical excision remains the treatment of choice.
Purvis
R S
RS
Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock.
Tyring
S K
SK
D000328:Adult; D003131:Combined Modality Therapy; D003613:Danazol / Q000627:therapeutic use*; D004715:Endometriosis / Q000188:drug therapy* / Q000601:surgery*; D005260:Female; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use*; D012871:Skin Diseases / Q000188:drug therapy* / Q000601:surgery*
D016729:Leuprolide; D003613:Danazol