Takaya Kento, Shido Hirokazu, Yamazaki Shun
Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan.
Yamato Municipal Hospital, Kanagawa, Yamato, Japan.
Case Rep Med. 2022 Apr 29;2022:7330013. doi: 10.1155/2022/7330013. eCollection 2022.
Currently, there are few reports describing the use of reconstructive techniques in the treatment of cesarean scar endometriosis (CSE). Here, we report a case of CSE, a rare form of endometriosis caused by scars from obstetric and gynecological surgeries. . A 50-year-old woman became aware of a painful, deep scar mass in her lower abdomen during her menstrual period 10 years after her second cesarean section. This was diagnosed as CSE after the biopsy. Under general anesthesia, the mass, a portion of the rectus abdominis, and a 1 cm tumor-free margin were resected as a whole, and the abdominal wall was reconstructed with a soft artificial mesh.
No obvious recurrence or subjective symptoms were observed postoperatively or reported in the 1-year follow-up period. . Endometriosis appearing in a cesarean scar is rare; it is chiefly triggered by intraoperative mechanical implantation. In cases of surgical scar masses with a history of gynecological surgery and associated menstrual symptoms, this syndrome should be considered during diagnosis and treatment.
目前，关于重建技术用于治疗剖宫产瘢痕子宫内膜异位症（CSE）的报道较少。在此，我们报告一例CSE病例，这是一种由妇产科手术瘢痕引起的罕见子宫内膜异位症形式。一名50岁女性在第二次剖宫产术后10年的月经期，发现下腹部有一个疼痛的深部瘢痕肿块。活检后诊断为CSE。在全身麻醉下，将肿块、部分腹直肌以及1厘米无肿瘤边缘整块切除，并用柔软的人工补片重建腹壁。
术后及1年随访期内均未观察到明显复发或主观症状。剖宫产瘢痕中出现子宫内膜异位症较为罕见；主要由术中机械植入引发。对于有妇科手术史且伴有月经相关症状的手术瘢痕肿块病例，诊断和治疗时应考虑此综合征。
