Abdominal wall endometriomas.
BACKGROUND
The diagnosis of abdominal wall endometriomas is often confused with other surgical conditions.


METHODS
A retrospective study was made of 12 patients presenting with an abdominal wall mass, which proved to be endometrioma.


RESULTS
Of a total of 297 patients of endometriosis treated in our hospital over a 7-year period, 12 (4%) had isolated abdominal wall endometriomas. Their mean age was 29.4 years. The presenting symptoms were abdominal mass (n = 12), cyclical (n = 5) or noncyclic pain (n = 7), dyspareunia and dysmenorrhea (n = 1). All patients had a history of gynecologic operations and presented, after an average of 1.9 years, with a tender mass (average 4 cm) at the previous incision site. Preoperative diagnosis was correct in 4 patients (33%) who presented with a cyclically painful abdominal mass. The others were diagnosed as incisional hernia (n = 4), "abdominal wall tumor" (n = 2), and inguinal hernia (n = 2). All patients underwent wide excision of their endometrioma; 2 required polytetrafluoroethylene patch grafting for the resulting fascial defect. The diagnosis was confirmed at frozen section or conventional histological examination in all patients. At follow-up, ranging from 4 months to 3 years, there was no recurrence of endometrioma.


CONCLUSIONS
Scar endometrioma commonly presents as an abdominal mass with noncyclical symptoms. Imaging techniques are nonspecific and needle biopsy may confirm the diagnosis. Wide excision is the treatment of choice for abdominal wall endometrioma as well as for recurrent lesions.
Blanco
Ray G
RG
Department of Surgery, Bronx-Lebanon Hospital Center, 1650 Selwyn Ave., 4th Floor, Suite 4F, Bronx, NY 10457, USA.
Parithivel
Vellore S
VS
Shah
Ajay K
AK
Gumbs
Milton A
MA
Schein
Moshe
M
Gerst
Paul H
PH
D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D034861:Abdominal Wall / Q000473:pathology* / Q000601:surgery; D000328:Adult; D002585:Cesarean Section; D002921:Cicatrix / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D004412:Dysmenorrhea / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D004414:Dyspareunia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D004715:Endometriosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D009135:Muscular Diseases / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications; D011247:Pregnancy; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome