title: Abdominal wall endometriosis: 12 years of experience at a large academic institution.
abstract: OBJECTIVE
  The objective of the study was to review patient characteristics and intraoperative findings for excised cases of abdominal wall endometriosis (AWE).
  
  
  METHODS
  A 12 year medical record search was performed for cases of excised AWE, and the diagnosis was confirmed on pathological specimen. Descriptive data were collected and analyzed.
  
  
  RESULTS
  Of 65 patients included, the primary clinical presentation was abdominal pain and/or a mass/lump (73.8% and 63.1%, respectively). Most patients had a history of cesarean section (81.5%) but 6 patients (9.2%) had no prior surgery. Time from the initial surgery to presentation ranged from 1 to 32 years (median, 7.0 years), and time from the most recent relevant surgery ranged from 1 to 32 years (median, 4.0 years). Five patients (7.7%) required mesh for fascial closure following the resection of the AWE. We were unable to demonstrate a correlation between the increasing numbers of open abdominal surgeries and the time to presentation or depth of involvement. Age, body mass index, and parity also were not predictive of depth of involvement. There were increased rates of umbilical lesions (75% vs 5.6%, P < .001) in nulliparous compared with multiparous women as well as in women without a history of cesarean section (66.7% vs 1.9%, P < .001).
  
  
  CONCLUSIONS
  In women with a mass or pain at a prior incision, the differential diagnosis should include AWE. Although we were unable to demonstrate specific characteristics predictive for AWE, a large portion of our population had a prior cesarean section, suggesting a correlation.
authors.affiliation: Department of Obstetrics and Gynecology, Magee-Womens Hospital of UPMC, Pittsburgh, PA.
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Ecker
authors.affiliation: Department of Obstetrics and Gynecology, Magee-Womens Hospital of UPMC, Pittsburgh, PA.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Donnellan
authors.affiliation: Department of Obstetrics and Gynecology, Magee-Womens Hospital of UPMC, Pittsburgh, PA.
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Shepherd
authors.affiliation: Department of Obstetrics and Gynecology, Magee-Womens Hospital of UPMC, Pittsburgh, PA.
authors.forename: Ted T M
authors.initials: TT
authors.lastname: Lee
mesh_terms: D034861:Abdominal Wall / Q000473:pathology / Q000601:surgery; D000328:Adult; D002585:Cesarean Section; D003937:Diagnosis, Differential; D004715:Endometriosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D011247:Pregnancy; D012189:Retrospective Studies
keywords: abdominal wall endometrioma; cutaneous endometriosis; extrapelvic endometriosis; incisional endometriosis; scar endometriosis