Archives of Aesthetic Plastic Surgery (Apr 2024)

Scar endometriosis as an easily misdiagnosed abdominal mass: a case report and review of the literature

  • Chi Hyun Lee,
  • Changryul Claud Yi,
  • Ji Hyun Ahn,
  • Joo Hyoung Kim

DOI
https://doi.org/10.14730/aaps.2024.01109
Journal volume & issue
Vol. 30, no. 2
pp. 82 – 85

Abstract

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Scar endometriosis, which is characterized by ectopic endometrial-like glands and stroma surrounding scar tissue, is rare and presents diagnostic challenges due to its inconsistent presentation. We report a case of a 40-year-old woman who had previously undergone two cesarean sections and a hysterectomy, in whom a mass in the subcutaneous layer of the lower abdomen was incidentally discovered by computed tomography (CT). A physical examination revealed a linear cesarean scar with a palpable, pigmented mass. An enhanced abdominal CT scan revealed an approximately 3.5-cm ill-defined soft tissue mass infiltrating the rectus abdominis muscle. A desmoid tumor was suspected based on the radiological findings, and endometriosis was also considered in light of the patient’s medical history. Wide mass excision was performed, ensuring 5-mm margins. The mass was completely excised, and a histopathological examination revealed endometriosis. Due to its rarity, scar endometriosis in the abdominal area can be easily misdiagnosed. Therefore, a heightened suspicion of scar endometriosis should be maintained in female patients with a history of abdominal or pelvic surgery presenting with an abdominal mass. Although imaging modalities can play a supportive role in the diagnosis, an extensive medical history assessment and comprehensive physical examination remain crucial.

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