Abdominal wall endometriosis: Report of 83 cases

Objective: To investigate the clinical course and management of abdominal wall endometriosis (AWE). Methods: A retrospective study was carried out from January 2010 to December 2020, at Vita-Nações Hospitals, Curitiba, Brazil, in order to evaluate data of patients undergoing surgery for the excision of AWE. Results: 83 women with AWE were included in the study. Umbilical scar endometriosis was found in 26 patients (31.3%), being primary in 20 cases (76.9%) and secondary to a laparoscopic procedure in 6 cases (23.1%). 2 patients had secondary implants outside the umbilicus after laparoscopic surgery. Secondary implant after cesarian section in 55 patients (66.3%). Diagnosis was made by ultrasound in 65 patients (78.3%) and by MRI in the remaining 18 (21.7%). Complete excision of the nodule was carried out and no case of recurrence was registered up to now. Conclusions: Painful abdominal mass presenting in women, especially with a previous history of abdominal and pelvic surgery, should be suspected of AWE. It occurs most often secondary to obstetric or gynecological surgeries and seems to be related to iatrogenic transfer of the endometrial tissue at the level of the surgical scar. Cesarean scar endometriosis is the most common presentation. Surgical excision including the surrounding fibrotic tissue should be performed.