Abdominal Wall Endometriosis Following Laparoscopic Endometrioma Surgery: A Case Report

Endometriosis is defined as the presence of ectopic, functioning endometrial tissue outside the uterine cavity. It is a common gynecological condition which is frequently located within the pelvis, but it can even be found in the lung, bowel, ureter and abdominal wall, etc. The expression ‘abdominal wall endometriosis (AWE)’ is used to indicate the presence of ectopic endometrium located far from the peritoneum, embedded in the subcutaneous fatty tissue and the abdominal wall muscle layers. AWE is a rare entity and occasionally presented to general surgeons as a lump in the abdomen. It can pose a diagnostic dilemma and should be in the differential diagnosis of lumps in the abdomen in females. Diagnosis is usually made following histological examination. This is a case report of abdominal wall endometriosis following laparoscopic endometrioma surgery. Case: A 26-year-old woman, gravida:1, para:1, referred to our hospital, after 4 years from her cesarean section and 3 years from laparoscopic endometrioma removal, complaining of a palpable mass around the umblicus which swells and pains during menses. The mass was firm, immobile and painless. Preoperative superficial tissue ultrasonography revealed a heterogenous mass under the skin just right side of the umblicus. Excision with a wide margin was performed and the histopathological diagnosis of the surgical specimen was endometriosis. Abdominal wall endometriosis is often misdiagnosed as a hernia, suture granuloma, primary or metastatic tumor hematoma or lipoma of the abdominal wall, thus resulting in unexpected findings at surgery. A correct preoperative diagnosis would help in counseling the patient and in planning appropriate surgery