A Rare Case of Scar Edometriosis - Case Report

Background: Scar endometriosis is a rare condition seen in post LSCS or hysterectomy or obstetric procedure, where functional endometrial tissue is seen outside uterine cavity. Case: A 34 year old female presented with cyclic pain during menstruation at the Pfannenstiel incision at the scar site, associated with 5 * 5 cm lump in the parietal abdominal plan. On clinical examination and investigations, preoperatively, it was suggestive of scar endometriosis. After excision, HPE confirmed to be scar endometriosis with 2 cm clear margins. Discussion: Scar endometriosis is a very rare disorder whose incidence was reported to be 0.03–0.45%. Clinical suspicion of scar endometriosis is very important in the patients with chronic pain at scar site, which is usually missed and can often lead to longterm morbidity of the patients. With histopathological confirmation it becomes absolutely necessary to prove iatrogenic implantation theory which is well accepted. Conclusion: Clinical suspicion of scar endometriosis depending on clinical presentation and history of previous obstetric procedure   is important for surgeons and excision of the lesion with good margins is the treatment of choice to prevent chronic morbidity in patients due to pain and recurrent surgery.