Case series of scar endometriosis- post caeserean section: A diagnostic pitfall

Abstract

The presence and growth of ectopic functional endometrial tissue outside the uterus is called endometriosis among which scar endometriosis is rare and difficult to diagnose. It occurs as a result of obstetrical and gynecological surgeries and can be confused with other surgical conditions. We reviewed the case records of patients with the diagnosis of scar endometriosis seen in our hospital from 2015 to 2018. We found six patients of scar endometriosis. The median age of the patients was 28.5 years (range 20-31 years) and median interval from symptoms to treatment was 4 years (range 2-6 years). Four patients had first presented to either the surgery or dermatology physicians. The most common complain being cyclical pain and swelling at local site. Patients underwent wide excision of the mass with no recurrence of symptoms at a follow up ranging from 9 months to 12 years. Confirmation of the diagnosis is histopathology with wide surgical excision being the treatment of choice. We have discussed the pathogenesis, diagnosis and treatment of this condition. Imaging techniques and FNAC are indicated towards better diagnostic approach and avoid confusion with other conditions. Medical treatment is helpful in selected cases only. After studying and presenting this paper we would like to highlight on such a rare condition and prevent its misdiagnosis.