Incision scar’s endometriosis case that was treated with false diagnosis

Yanlış teşhis ile tedavi edilmiş, bir insizyon skari endometriozisi olgusu

Abstract

Endometriosis is defined as the placement of a functional endometrium tissue outside the uterine cavity. Abdominal-wall endometriosis is usually observed after obstetric and gynecological operations. Endometriosis masses located in incision scars can be confused with foreign body reaction, granulomas, abscess, and incisional hernia. A 45-year-old female patient, who had undergone cesarean section 14 years ago, presented to our clinic for pain on the left side of the incision for 6 months and particularly because of the painful mass that grew during menstruation in that region. The patient was misdiagnosed as reactive lymphadenopathy due to fungal and bacterial infections in her toes before presenting to our clinic, and she was treated for a long time with this false diagnosis. On the left side of the Pfannen-Stiel incision, a non-mobile, painful mass of about 2×1 cm, with moderate
stiffness, was detected on the physiological examination of the patient. Superficial ultrasonography applied to the region showed lobulated contour, mild heterogeneous hypoechoic, and mild vascularized solid lesion sized 10.4×3.4×10 mm on the left side of the incision line. The patient underwent surgery with an initial diagnosis of endometriosis in the incision scar. The received tissue was sent for pathological examination, and she was diagnosed as endometriosis. Thus, if a mass is detected in the anterior wall of the abdomen in women who had undergone cesarean delivery, the possibility of endometriosis should not be overlooked after the patient’s history has been cautiously taken and physical examination and radiological examinations have been performed.