Cesarean scar endometriosis

Abstract

Abdominal wall endometriosis (AWE) consists of the presence of endometriotic tissue in the anatomical layers of the abdominal wall. Cesarean scar endometriosis (CSE) is the most common site of abdominal wall endometriosis. The incidence of CSE, reported in most of the studies, is around 0.03-1%. The most common clinical presentation of CSE is a painful palpable abdominal mass under or adjacent to the surgical incision. The endometriotic nodule may be clinically characterized by cyclic or noncyclic pain. The ultrasound with a transabdominal linear probe is the first line of radiological examination in patients with suspicion of CSE. At the ultrasound, CSE appears as oval or rounded, hypoechoic, heterogeneous nodules surrounded by a hyperechoic area. The treatment of CSE is basically surgical: the endometriotic nodule should be removed en bloc surrounded by an adequate margin of healthy tissue to avoid recurrence of the disease.