Trocar scar abdominal wall adenomyoma following laparoscopic hysterectomy: case report.

Abstract

Abdominal wall endometriosis (AWE) within the scar of a trocar insertion is seldom reported as a complication of laparoscopy. We describe the case of a 46 year-old woman suffering from uterine leiomyomas who underwent laparoscopic hysterectomy. One year later, she developed a painful abdominal wall mass, beneath the scar of suprapubic port-site trocar insertion. The diagnostic work-up, consisting in ultrasonography, magnetic resonance imaging and needle biopsy led to a diagnosis of AWE. Initially, a progestogen therapy was administered, obtaining relief from pain symptoms but insignificant reduction of lump' size. Therefore, the patient underwent a laparotomic resection of the mass. Pathologic findings showed endometriotic tissue mixed with smooth muscle cells, leading to the diagnosis of extrauterine adenomyoma. Six months after surgery, neither AWE relapse nor incisional hernia was found. To our knowledge, no case of parasitic adenomyoma development in a trocar scar following a laparoscopy has been described before in literature.