Perineal Endometriosis in an Episiotomy Scar: Case Report and Review of Literature

Abstract

Purpose Perineal endometriosis is a rare disease characterized by the presence of ectopic endometrial stroma and glands in the perineum. Most commonly observed in the episiotomy scar after normal vaginal deliveries, perineal endometriosis is not often considered in the differential diagnosis of perineal masses. This could lead to unnecessary investigations and inadequate patient treatments. Case Report A 41-year-old woman complains of a tender perineal mass, which becomes hard and more painful during menses. Her symptoms started five years prior in the same area where a midline episiotomy was performed during a normal vaginal delivery. Complete surgical excision of the perineal mass was performed and the pathology report confirmed perineal endometriosis. No recurrence was noted on the postoperative course. Conclusion A comprehensive history and meticulous pelvic examination are essential in diagnosing perineal endometriosis. Surgical intervention is the best approach for treatment and permanent cure is usually achieved after complete excision of the perineal endometriosis.