A case of Abdominal Wall Endometriosis at the Caesarean Section Scar

Abstract

　　We experienced a case of abdominal wall endometriosis (AWE) that arised from the caesarean section scar. The patient was a woman in her 40s. She visited our hospital for an abdominal wall mass accompanied by periodically pain that was noticed half a year previously. She had undergone a caesarean section 2 years ago, and had a subcutaneous tumor of 2 cm in size on the cranial edge of the scar. Ultrasonography revealed a heterogeneous hypoechoic mass on the anterior layer of the rectus sheath, and magnetic resonance imaging revealed a nodule with a low signal intensity on T1-weighted imaging and mild high signal intensity on T2-weighted imaging. We suspected AWE, and she underwent tumor resection under general anesthesia. A histopathological examination revealed endometrial glands and stroma in the tissues, confirming the diagnosis of AWE. AWE is expected to increase due to an increase in the number of caesarean sections performed worldwide. We should consider AWE as a differential diagnosis in women with subcutaneous tumors associated with menstrual cyclic pain or swelling in the incisional scar after caesarean section and other abdominal surgery.