Scar endometriosis

Case contributed by Dr James Harvey

Presentation

Focal tenderness to right lower anterior abdominal wall persisting over 4 months. Background of previous LCSC.

Patient Data

Age: 30-40 years
Gender: Female
CT
  • Small (11 mm) soft tissue density focus contiguous with the anterior margin of the right pelvic rectus sheath immediately medial to the right lower linea semilunaris.
  • A hernia is not seen at this site and there is minimal adjacent inflammatory change.
  • No intra-abdominal pathology
Ultrasound

Small (12 x 7 x 8mm) hypoechoic, well-circumscribed lesion within the deep abdominal wall. No associated vascularity. No movement/herniation with valsalva.

Ultrasound

Fine needle aspirate

USS-guided FNA was performed.

Case Discussion

HISTOLOGY:
Sections show fibrous tissue cores with sparse lymphocytic infiltration.  In
some foci there are plump cells in an edematous stroma associated with
columnar ciliated epithelium. PAX8 is positive in the epithelium.  CD10 shows diffuse staining
and is difficult to interpret.   There is no evidence of dysplasia or
malignancy in the tissue sampled.

SUMMARY
Abdominal wall biopsy: suspicious for endometriosis/endosalpingiosis.

DISCUSSION
Location is typical for scar endometropsis. Vascularity can often be increased in these lesions.
 

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Case information

rID: 74233
Published: 14th Feb 2020
Last edited: 16th Feb 2020
Inclusion in quiz mode: Included

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