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Background <p>Abdominal wall endometriosis (AWE) is a rare form of extrapelvic endometriosis, often developing after cesarean section. While typically presenting as a painful mass near surgical scars, its diagnosis is frequently delayed. This study investigates the clinical features, muscle fascia involvement, and surgical outcomes in patients with AWE.</p> Methods <p>A retrospective review was performed on 21 patients with histologically confirmed AWE treated surgically at a tertiary care center between January 2016 and December 2020. Patient demographics, clinical presentation, lesion characteristics, fascia involvement, surgical techniques, and recurrence rates were analyzed.</p> Results <p>All patients had a prior cesarean section. The most common symptom was a cyclic painful mass (76.2%). Muscle fascia invasion was detected in 42.9% of cases. Polypropylene mesh repair was used in defects ≥ 3&#xa0;cm. Only one recurrence (4.8%) was observed during a mean follow-up of 22 months. A strong correlation existed between physical and radiologic lesion size (<i>r</i> = 0.923), and between symptom duration and time since cesarean (<i>r</i> = 0.579).</p> Conclusion <p>AWE should be considered in women with abdominal wall masses and cesarean history. Wide excision is effective, and mesh repair offers reliable outcomes in fascia-invading cases. Early recognition and tailored surgical planning help minimize recurrence.</p>

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Beyond the scar: a retrospective analysis of a rare subtype of abdominal wall endometriosis with muscle fascia invasion and its surgical implications

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月9日

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  • Muhammet Fatih Keyif,
  • Sabahattin Destek,
  • Betül Keyif

摘要

Background

Abdominal wall endometriosis (AWE) is a rare form of extrapelvic endometriosis, often developing after cesarean section. While typically presenting as a painful mass near surgical scars, its diagnosis is frequently delayed. This study investigates the clinical features, muscle fascia involvement, and surgical outcomes in patients with AWE.

Methods

A retrospective review was performed on 21 patients with histologically confirmed AWE treated surgically at a tertiary care center between January 2016 and December 2020. Patient demographics, clinical presentation, lesion characteristics, fascia involvement, surgical techniques, and recurrence rates were analyzed.

Results

All patients had a prior cesarean section. The most common symptom was a cyclic painful mass (76.2%). Muscle fascia invasion was detected in 42.9% of cases. Polypropylene mesh repair was used in defects ≥ 3 cm. Only one recurrence (4.8%) was observed during a mean follow-up of 22 months. A strong correlation existed between physical and radiologic lesion size (r = 0.923), and between symptom duration and time since cesarean (r = 0.579).

Conclusion

AWE should be considered in women with abdominal wall masses and cesarean history. Wide excision is effective, and mesh repair offers reliable outcomes in fascia-invading cases. Early recognition and tailored surgical planning help minimize recurrence.