title: Surgical scar endometriosis.
abstract: Endometriosis is a common disorder in females of reproductive age. Surgical scar endometrioma after cesarean section develops in 1-2% of patients, and usually presents as a tender and painful abdominal wall mass. The diagnosis is suggested by pre or perimenstrual pelvic pain and is often established only by histology. In this retrospective observational cohort study, we reviewed the medical records of five patients with a histopathological diagnosis of scar endometriosis. A scar mass was found on a previous Pfannenstiel incision in four patients and in a median cesarean section in one patient. The mean age at diagnosis (38.6 years, median 38) was older than reported elsewhere. A histological examination of the surgical specimen confirmed the diagnosis of endometriosis in all cases. During the follow-up period (mean 34.6 months), local recurrence (n = 1) and pelvic recurrence (n = 1) were treated surgically. Surgery is the treatment of choice for surgical scar endometriosis. Excision with histologically proven free surgical margins of 1 cm is mandatory to prevent recurrence. As scar endometriosis may be associated with pelvic localization, explorative abdominal laparoscopy may be indicated to exclude the intraperitoneal spread of the disease in symptomatic patients.
authors: Department of Digestive and Colorectal Surgery, Centre of Minimal Invasive Surgery, Molinette Hospital, University of Turin, Cso A.M. Dogliotti 14, 10126, Turin, Italy, mistrangelo@katamail.com.
authors: Massimiliano
authors: M
authors: Mistrangelo
authors: Nicholas
authors: N
authors: Gilbo
authors: Paola
authors: P
authors: Cassoni
authors: Salvatore
authors: S
authors: Micalef
authors: Riccardo
authors: R
authors: Faletti
authors: Claudio
authors: C
authors: Miglietta
authors: Raffaele
authors: R
authors: Brustia
authors: Gisella
authors: G
authors: Bonnet
authors: Gianluca
authors: G
authors: Gregori
authors: Mario
authors: M
authors: Morino
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D034861:Abdominal Wall; D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects; D002921:Cicatrix / Q000209:etiology*; D015331:Cohort Studies; D004715:Endometriosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D010532:Peritoneal Diseases / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D055502:Secondary Prevention