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Surgical scar endometriosis

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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.

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Author notes

  1. Massimiliano Mistrangelo

    Present address: , Via Carlo Alberto Dalla Chiesa 1/R, 10040, Volvera, TO, Italy

Authors and Affiliations

  1. Department of Digestive and Colorectal Surgery, Centre of Minimal Invasive Surgery, Molinette Hospital, University of Turin, Cso A.M. Dogliotti 14, 10126, Turin, Italy

    Massimiliano Mistrangelo, Nicholas Gilbo, Claudio Miglietta, Raffaele Brustia, Gisella Bonnet & Mario Morino

  2. Department of Biomedical Sciences and Human Oncology, Molinette Hospital, University of Turin, Turin, Italy

    Paola Cassoni

  3. Department of Oncological Gynaecology, Sant’Anna Hospital, Turin, Italy

    Salvatore Micalef & Gianluca Gregori

  4. Department of Radiology, Molinette Hospital, University of Turin, Turin, Italy

    Riccardo Faletti

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  1. Massimiliano Mistrangelo
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  2. Nicholas Gilbo
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Correspondence to Massimiliano Mistrangelo.

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Mistrangelo, M., Gilbo, N., Cassoni, P. et al. Surgical scar endometriosis. Surg Today 44, 767–772 (2014). https://doi.org/10.1007/s00595-012-0459-3

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  • DOI: https://doi.org/10.1007/s00595-012-0459-3

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