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ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

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Research Article

Clinical Features of Extragenital Scar Endometriosis: A Cross-Sectional Study

Author(s): Beatriz Ferro*, João Martins Gama*, Mariana Robalo Cordeiro and Margarida Figueiredo-Dias

Volume 20, Issue 2, 2024

Published on: 27 March, 2023

Article ID: e230223213967 Pages: 6

DOI: 10.2174/1573404820666230223123036

Price: $65

Abstract

Objective: Abdominal wall endometriosis (AWE) is a rare form of extragenital endometriosis that usually develops in association with a prior surgical scar. The purpose of the study was to review the clinical characteristics, diagnostic methods, treatment modalities, and outcomes of patients with AWE.

Methods: A descriptive cross-sectional study was performed in a Gynecology Department of a Portuguese tertiary hospital, concerning patients with histologic-proven AWE, between January 2012 and December 2020 (n = 22). Statistical analysis was performed using IBM SPSS Statistics Version 27.00, with a significance level of p < 0.05.

Results: The most common locations of extrapelvic endometrial ectopic implants were cesarean delivery scar (n = 13, 59.1%) and the umbilicus (n = 5, 22.7%). The median (range) age was 36 (30-42) years old, and all patients had a history of previous surgery but one. Nineteen patients had undergone a previous cesarean section, and the mean (range) time from surgery to the onset of symptoms was 100 (32-168) months. All patients were symptomatic and presented with a palpable mass at physical examination. The majority complained of a painful abdominal mass (n = 20, 90.9%) which was associated with cyclic pain in thirteen patients (65%). Ultrasound scan was performed in all patients and the nodules had a median size of 20.5 mm (5-93 mm). One patient received hormonal therapy and surgical resection was performed in the remaining patients. The nodule’s median (range) size was 31 (12-50) mm on gross examination.

Conclusion: AWE should be considered in the presence of a previous pelvic surgery history associated with abdominal scar cyclic pain and swelling. A careful history and clinical examination are essential for diagnosis to avoid unnecessary delay before surgical intervention.

Keywords: Abdominal endometriosis, endometriosis, umbilical endometriosis, scar endometriosis, cesarean section, pelvic surgery.

Graphical Abstract

[1]
Buscemi, S.; Maiorana, A.; Fazzotta, S.; Incandela, D.; Palumbo, V.D.; Damiano, G.; Maffongelli, A.; Messina, M.; Bisso, C.; Anzelmo, G.; Curione, F.; Cantavenera, V.; Bellomo, E.; Raia, V.E.; Scimeca, R.; Geraci, G.; Cudia, B.M.; Lo Monte, A.I. Scar endometriosis: Not a rare cause for a painful scar. Clin. Ter., 2021, 172(2), 129-133.
[PMID: 33763680]
[2]
Doroftei, B.; Armeanu, T.; Maftei, R.; Ilie, O.D.; Dabuleanu, A.M.; Condac, C. Abdominal wall endometriosis: Two case reports and literature review. Medicina, 2020, 56(12), 727.
[http://dx.doi.org/10.3390/medicina56120727] [PMID: 33371515]
[3]
Zhang, P.; Sun, Y.; Zhang, C.; Yang, Y.; Zhang, L.; Wang, N.; Xu, H. Cesarean scar endometriosis: Presentation of 198 cases and literature review. BMC Womens Health, 2019, 19(1), 14.
[http://dx.doi.org/10.1186/s12905-019-0711-8] [PMID: 30658623]
[4]
Khan, Z.; Zanfagnin, V.; El-Nashar, S.A.; Famuyide, A.O.; Daftary, G.S.; Hopkins, M.R. Risk factors, clinical presentation, and outcomes for abdominal wall endometriosis. J. Minim. Invasive Gynecol., 2017, 24(3), 478-484.
[http://dx.doi.org/10.1016/j.jmig.2017.01.005] [PMID: 28104496]
[5]
Lopez-Soto, A.; Sanchez-Zapata, M.I.; Martinez-Cendan, J.P.; Ortiz Reina, S.; Bernal Mañas, C.M.; Remezal Solano, M. Cutaneous endometriosis: Presentation of 33 cases and literature review. Eur. J. Obstet. Gynecol. Reprod. Biol., 2018, 221, 58-63.
[http://dx.doi.org/10.1016/j.ejogrb.2017.11.024] [PMID: 29310043]
[6]
Grigore, M.; Socolov, D.; Pavaleanu, I.; Scripcariu, I.; Grigore, A.M.; Micu, R. Abdominal wall endometriosis: An update in clinical, imagistic features, and management options. Med. Ultrason., 2017, 19(4), 430-437.
[http://dx.doi.org/10.11152/mu-1248] [PMID: 29197920]
[7]
Chamié, L.P.; Ribeiro, D.M.F.R.; Tiferes, D.A.; Macedo Neto, A.C.; Serafini, P.C. Atypical sites of deeply infiltrative endometriosis: Clinical characteristics and imaging findings. Radiographics, 2018, 38(1), 309-328.
[http://dx.doi.org/10.1148/rg.2018170093] [PMID: 29320327]
[8]
Tatli, F.; Gozeneli, O.; Uyanikoglu, H.; Uzunkoy, A.; Yalcın, H.C.; Ozgonul, A.; Bardakci, O.; Incebiyik, A.; Guldur, M.E. The clinical characteristics and surgical approach of scar endometriosis: A case series of 14 women. Bosn. J. Basic Med. Sci., 2018, 18(3), 275-278.
[http://dx.doi.org/10.17305/bjbms.2018.2659] [PMID: 29285999]
[9]
Makena, D.; Obura, T.; Mutiso, S.; Oindi, F. Umbilical endometriosis: A case series. J. Med. Case Reports, 2020, 14(1), 142.
[http://dx.doi.org/10.1186/s13256-020-02492-9] [PMID: 32892752]
[10]
Andres, M.P.; Arcoverde, F.V.L.; Souza, C.C.C.; Fernandes, L.F.C.; Abrão, M.S.; Kho, R.M. Extrapelvic endometriosis: A systematic review. J. Minim. Invasive Gynecol., 2020, 27(2), 373-389.
[http://dx.doi.org/10.1016/j.jmig.2019.10.004] [PMID: 31618674]
[11]
Taniguchi, F.; Hirakawa, E.; Azuma, Y.; Uejima, C.; Ashida, K.; Harada, T. Primary umbilical endometriosis: Unusual and rare clinical presentation. Case Rep. Obstet. Gynecol., 2016, 2016, 9302376.
[http://dx.doi.org/10.1155/2016/9302376]
[12]
Matalliotakis, M.; Matalliotaki, C.; Zervou, M.I.; Krithinakis, K.; Goulielmos, G.N.; Kalogiannidis, I. Abdominal and perineal scar endometriosis: Retrospective study on 40 cases. Eur. J. Obstet. Gynecol. Reprod. Biol., 2020, 252, 225-227.
[http://dx.doi.org/10.1016/j.ejogrb.2020.06.054] [PMID: 32623253]
[13]
Pas, K.; Joanna, S.M.; Renata, R.; Skręt, A.; Barnaś, E. Prospective study concerning 71 cases of caesarean scar endometriosis (CSE). J. Obstet. Gynaecol., 2017, 37(6), 775-778.
[http://dx.doi.org/10.1080/01443615.2017.1305333] [PMID: 28395567]
[14]
Yıldırım, D.; Tatar, C.; Doğan, O.; Hut, A.; Dönmez, T.; Akıncı, M.; Toptaş, M.; Bayık, R.N. Post-cesarean scar endometriosis. J. Turkish Soc. Obstetric Gynecol., 2018, 15(1), 33-38.
[http://dx.doi.org/10.4274/tjod.90922] [PMID: 29662714]
[15]
Ince, C.; Wagner, A.; Rajakumar, C. Abdominal wall endometriosis. J. Obstet. Gynaecol. Can., 2018, 40(7), 859.
[http://dx.doi.org/10.1016/j.jogc.2017.03.107] [PMID: 28606452]
[16]
Yela, D.; Trigo, L.; Benetti-Pinto, C. Evaluation of cases of abdominal wall endometriosis at Universidade Estadual de Campinas in a period of 10 years. Rev. Bras. Ginecol. Obstet., 2017, 39(8), 403-407.
[http://dx.doi.org/10.1055/s-0037-1603965] [PMID: 28637058]
[17]
Jaramillo-Cardoso, A.; Balcacer, P.; Garces-Descovich, A.; Beker, K.; Roth, E.; Glickman, J.; Mortele, K.J. Multimodality imaging and clinicopathologic assessment of abdominal wall endometriosis: Knocking down the enigma. Abdom. Radiol., 2020, 45(6), 1800-1812.
[http://dx.doi.org/10.1007/s00261-018-1666-1] [PMID: 30003273]
[18]
Hirata, T.; Koga, K.; Kitade, M.; Fukuda, S.; Neriishi, K.; Taniguchi, F.; Honda, R.; Takazawa, N.; Tanaka, T.; Kurihara, M.; Nakajima, J.; Horie, S.; Nakai, H.; Enomoto, T.; Mandai, M.; Narahara, H.; Kitawaki, J.; Harada, T.; Katabuchi, H.; Yoshimura, K.; Osuga, Y. A national survey of umbilical endometriosis in Japan. J. Minim. Invasive Gynecol., 2020, 27(1), 80-87.
[http://dx.doi.org/10.1016/j.jmig.2019.02.021] [PMID: 30965115]
[19]
Hirata, T.; Koga, K.; Kai, K.; Katabuchi, H.; Kitade, M.; Kitawaki, J.; Kurihara, M.; Takazawa, N.; Tanaka, T.; Taniguchi, F.; Nakajima, J.; Narahara, H.; Harada, T.; Horie, S.; Honda, R.; Murono, K.; Yoshimura, K.; Osuga, Y. Clinical practice guidelines for the treatment of extragenital endometriosis in Japan, 2018. J. Obstet. Gynaecol. Res., 2020, 46(12), 2474-2487.
[http://dx.doi.org/10.1111/jog.14522] [PMID: 33078482]

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