Scar endometriosis: not a rare cause for a painful scar
V. 172 N. 2 (2021), Research article
V. 172 N. 2 (2021)

Scar endometriosis: not a rare cause for a painful scar: doi: 10.7417/CT.2021.2299

Research article
Pubblicato 2021-03-16
Salvatore Buscemi
Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo
Antonio Maiorana
Department of Obstetrics and Gynaecology, ARNAS Civico Hospital, Palermo
Salvatore Fazzotta
Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo
Domenico Incandela
Department of Obstetrics and Gynaecology, ARNAS Civico Hospital, Palermo
Vincenzo Davide Palumbo
Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo
Giuseppe Damiano
Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo
Bianca Maria Cudia
Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo
Attilio Ignazio Lo Monte
Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo
A. Maffongelli
Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo
M. Messina
Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo
C. Bisso
Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo
G. Anzelmo
Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo
F. Curione
Department of Molecular Medicine, Legal Medicine, University of Padua, Padua
V. Cantavenera
Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo
E. Bellomo
Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo
V. E. Raia
Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo
R. Scimeca
Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo
G. Geraci
Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo
PDF

Parole chiave

Scar endometriosis
caesarean section
nodular abdominal mass
painful scar

Abstract

Introduction: Endometriosis has been described as the presence of endometrial tissue outside uterine cavity. Scar endometriosis (SE) is a rare disease reported in 0.03-1.08% of women following gynaecologic surgery. In our retrospective observational cohort study we studied anamnesis, symptoms, surgical procedures and outcomes linked to scar endometriosis in our medical experience from 2004 to 2018.  

Methods: We reviewed the medical records of 46 patients with a histopathological diagnosis of SE. All patients had a history of at least one previous caesarean section (n=46, 100%). Forty-two patients (91,3%) complained gradually growing nodular abdominal mass near or adjacent to caesarean incision scar, while only 4 patients (8,6%) complained aspecific abdominal pain. Ultrasound scan was performed in all patients (n=46, 100%) and mean size of the nodules at US was 26,8 ± 13,8 mm.

Results: All patients underwent surgery. Seven patients (15,2%) needed mesh implantation, while 39 patients (84,8%) underwent local resection with reconstruction of muscle fascia. Mean follow-up was 31,6 ± 14 months and no patients reported local recurrence of disease.

Conclusion: high suspicion of scar endometriosis are painful nodule in the abdominal scar. Wide surgical excision is the treatment of choice.

PDF