Yin Weiyao, Zhang Jiawen, Xu Liangzhi, Luo Li
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.
Medicine (Baltimore). 2018 Apr;97(15):e0376. doi: 10.1097/MD.0000000000010376.
During the surgical procedure, endometrial cells can be seeded into the wound edge of the uterine wall, developing into scar endometriosis. Due to the extremely low incidence, estimation of its prevalence is still unavailable. Even rarer might be the scar endometriosis in uterine cavity, to our best knowledge, a situation has not been reported yet.
A 37-year-old woman complained of heavier and prolonged menstruation as well as pelvic pain during menses for more than 4 months. An endometrial cyst in diameter of 6 cm in uterine cavity was revealed by transvaginal ultrasound. Her surgical history was significant for 1 caesarean section and 1 abdominal myomectomy through transverse incision of lower uterine segment.
Space-occupying lesions in uterine cavity, moderate anemia and scar uterus.
The hysteroscopy was performed and a multilocular cyst full of chocolate-like fluid was removed. Pathological examination confirmed endometrial glands in the removed cyst tissue.
During the follow-up visits at 1 and 6 months after surgery, the patient denied any special discomfort. Her postoperative transvaginal ultrasound showed an enlarged uterus with no lesion in uterine cavity. To achieve a better surveillance, a 3-year period of follow-up after surgery at a 6-month interval was suggested.
Intrauterine endometriosis should be considered in patients of pelvic surgery history with pelvic pain, menstrual disorder, and intrauterine cystic mass.
在外科手术过程中，子宫内膜细胞可种植于子宫壁的伤口边缘，发展为瘢痕性子宫内膜异位症。由于其发病率极低，目前仍无法估计其患病率。据我们所知，子宫腔内的瘢痕性子宫内膜异位症更为罕见，尚无相关报道。
一名37岁女性因月经量大、经期延长以及经期盆腔疼痛4个多月前来就诊。经阴道超声检查发现子宫腔内有一个直径6厘米的子宫内膜囊肿。她有剖宫产史1次，经子宫下段横切口行腹部肌瘤切除术1次。
子宫腔内占位性病变、中度贫血和瘢痕子宫。
进行了宫腔镜检查，切除了一个充满巧克力样液体的多房囊肿。病理检查证实切除的囊肿组织中有子宫内膜腺体。
术后1个月和6个月随访时，患者否认有任何特殊不适。术后经阴道超声检查显示子宫增大，宫腔内无病变。为了更好地进行监测，建议术后进行为期3年的随访，每6个月随访一次。
有盆腔手术史、盆腔疼痛、月经紊乱和宫腔内囊性肿物的患者应考虑子宫内子宫内膜异位症。
