Abstract
Background and Objectives: Scar endometrioma is a rare event following cesarean section and in some cases after hysterectomy and pelvic laparoscopy. Patients with scar endometrioma are usually referred to general surgeon with diagnosis of incisional hernia or lipoma. Here, we present nine patients with diagnosis of mass in the surgical scar to emphasize the diagnostic procedures and therapeutical measures.
Materials and Methods: Retrospectively, confirmed cases of scar endometrioma based on pathology reports in medical documents were selected. Data including clinical presentation, duration of symptoms, interval between operation and onset of the clinical symptoms, preoperative assessment and management were collected.
Results: The mean age of patients was 29.7 years. In most patients, the common symptom was painful lump in the scar of previous cesarean section or laparotomy incision for ectopic pregnancy. Accurate preoperative diagnosis was made only in two patients. The duration of symptoms ranged from 3 months to 3 years. Ultrasonography or CT Scan had a little role in identifying the exact diagnosis. All patients underwent exploration and wide excision of the lump. There was no recurrence within a four-years follow up of the patients.
Conclusion: Scar endometrioma is an important differential diagnosis in patients presenting with a painful lump in scars for caesarean section or laparotomy for ectopic pregnancy. Although extensive diagnostic work up has been suggested, surgical excision is both diagnostic and curative.