Lopez-Soto Alvaro, Sanchez-Zapata Maria Isabel, Martinez-Cendan Juan Pedro, Ortiz Reina Sebastian, Bernal Mañas Carmen Maria, Remezal Solano Manuel
Department of Gynecology, HGU Santa Lucía, Cartagena, Spain; Doctoral Program in Health Sciences. Catholic University of Murcia (UCAM), Murcia, Spain.
Department of Gynecology, HGU Santa Lucía, Cartagena, Spain.
Eur J Obstet Gynecol Reprod Biol. 2018 Feb;221:58-63. doi: 10.1016/j.ejogrb.2017.11.024. Epub 2017 Dec 7.
Cutaneous endometriosis is a rare condition that usually affects the abdominal wall in women with a history of open abdominal surgery. It has a characteristic clinical picture of a mass and pain associated with menstruation. The diagnosis is difficult on being an uncommon and little known condition. Once there is suspicion, a correct anamnesis and examination is usually sufficient. The treatment is normally surgery.
The study included all women identified with a diagnosis of cutaneous endometriosis over a period of 20 years. The variables collected and analysed included, age, surgical history, gynaecology history, symptoms, time period between surgery and consultation, specialist consulted, location, size, tests performed, treatment, and recurrence.
A total of 33 women were identified, with a mean age of 35.4 ± 2.33 years. A surgical history was found in 31 (93%) of 33 women. The main symptom was abdominal mass (96%), followed by period pain (51%), and non-period pain (42%). The initial diagnosis was correct in 15 (45%) of 33 women, and after performing further tests it was correct in 23 (69%) of 33 women. The main additional test was fine needle aspiration (FNA) in 24 (72%) of 33 patients. Surgery was performed on 30 (90%) of 33 women, with 8 (24%) women requiring a prosthesis. There was a recurrence of cutaneous endometriosis in 3 (9%) women.
Although it is a rare disease, its association with gynaecological surgery, and in particular caesarean section, means that there should be more awareness of this condition. Its diagnosis may be complicated due to lack of knowledge, when a proper examination and anamnesis can give us the key.
皮肤子宫内膜异位症是一种罕见疾病，通常影响有开腹手术史的女性腹壁。它具有与月经相关的肿块和疼痛的典型临床表现。由于这种疾病不常见且鲜为人知，诊断较为困难。一旦产生怀疑，通常详细的病史询问和检查就足够了。治疗通常为手术。
该研究纳入了20年间所有确诊为皮肤子宫内膜异位症的女性。收集并分析的变量包括年龄、手术史、妇科病史、症状、手术至会诊的时间间隔、咨询的专科医生、部位、大小、进行的检查、治疗及复发情况。
共确定了33名女性，平均年龄为35.4 ± 2.33岁。33名女性中有31名（93%）有手术史。主要症状为腹部肿块（96%），其次是经期疼痛（51%）和非经期疼痛（42%）。33名女性中有15名（45%）初步诊断正确，进一步检查后33名女性中有23名（69%）诊断正确。主要的附加检查是33名患者中的24名（72%）进行了细针穿刺抽吸（FNA）。33名女性中有30名（90%）接受了手术，其中8名（24%）女性需要假体。3名（9%）女性出现了皮肤子宫内膜异位症复发。
尽管这是一种罕见疾病，但它与妇科手术尤其是剖宫产的关联意味着应该对这种疾病有更多认识。由于缺乏了解，其诊断可能会很复杂，而恰当的检查和病史询问能为我们提供关键线索。
