Abdominal wall endometrioma far from previous scar

Autores/as

  • Luis Ladaria-Sureda
  • Juan José Segura-Sampedro MD, PhD. Hospital Universitario Son Espases, Palma de Mallorca http://orcid.org/0000-0003-0565-3791
  • Elías Palma-Zamora
  • Francisco Javier González-Argenté

Palabras clave:

Endometriosis, Abdominal wall

Resumen

 

Endometriosis is defined by the presence of ectopic endometrial tissue that can respond to ovarian hormonal stimulation. Abdominal wall endometrioma prevalence is about 0.1-1%, the diagnosis can represent a challenge for the surgeon.

We present the case of a 28-year-old woman with a personal history of cesarean delivery 7 years ago who consulted due to pain relating to a mass in her right lateral abdominal wall. Physical examination showed a 2 cm nodular mass at the right lower quadrant, 10 cm away from the Pfannenstiel scar. Palpation was painful and no protrusion was felt after Valsalva or during bipedestation. Ultrasound and CT scan showed a 17 mm nodular mass at the union of oblique muscles and rectus abdominis muscle. With these findings we performed surgery to remove the mass and the specimen analysis confirmed endometrioma.

In our case the seed of this endometrioma probably took place during the previous surgery. Despite the fact that there was apparently no relation with the skin scar, it seems that it could have been sown during the dissection of the abdominal wall while gaining access to the uterus.

Differential diagnosis should be made with lymphatic node and granuloma. Surgery with free margins (more than 1 cm) is the definitive treatment. If needed, synthetic mesh placement can be indicated.

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Citas

1. Nissotakis C, Zouros E, Revelos k et al.: Abdominal Wall Endometrioma: A Case Report and Review of the Literature. AORN Journal 2010 91:730-745
2. Khamechian T, Alizagar J, Mazoochi T: 5-Year data analysis of patients following abdominal wall endometrioma surgery. BMC Women's Health 2014 14:151.
3. Heller D, Fitzhugh V: Abdominal Wall Endometriosis: A Rarely Anticipated Diagnosis A 16-Year Experience and Brief Literature Review. The Journal of Reproductive Medicine 2014 59:110-112.
4. Nigam A. Subcutaneous endometriosis: a rare cause of deep dyspareunia BMJ Case Rep. 2014
5. Vinchant M, Poncelet C, Ziol M, et al.: Malignant transformation of abdominal wall endometriosis: case report and literature review. Tumor 2013, 99: e49-e54

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Publicado

2018-08-31

Cómo citar

Ladaria-Sureda, L., Segura-Sampedro, J. J., Palma-Zamora, E., & González-Argenté, F. J. (2018). Abdominal wall endometrioma far from previous scar. Annals of Mediterranean Surgery, 1(2), 3–5. Recuperado a partir de https://edicions.uib.cat/ojs/index.php/AMS/article/view/409

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Reporte de un caso

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