Purvis R S, Tyring S K
Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock.
J Dermatol Surg Oncol. 1994 Oct;20(10):693-5. doi: 10.1111/j.1524-4725.1994.tb00456.x.
Cutaneous or subcutaneous endometriosis is a rare entity that should be suspected in any female presenting with cyclic pain emanating from a mass in the vicinity of an abdominal surgical scar or the umbilicus.
The purpose of this report is to examine the diagnostic procedures for endometriosis and to review the therapeutic value of surgical excision alone or in combination with hormonal treatment.
Endometriosis presenting cutaneously in an infraumbilical laparoscopy scar and endometriosis occurring subcutaneously in a cesarean section scar were both diagnosed via incisional biopsy. Both lesions were treated with hormonal therapy followed by surgical excision.
Hormonal therapy with danazol or with leuprolide resulted in reduction of symptoms but was associated with amenorrhea in both cases and with dyspareunia in the second patient. Subsequent laparoscopy and surgical excision of the endometrioma were curative.
Preoperative hormonal therapy, although sometimes associated with such side effects as amenorrhea, may be used in cases of large endometriotic masses to reduce the size of the surgical defect, but surgical excision remains the treatment of choice.
皮肤或皮下子宫内膜异位症是一种罕见的病症，对于任何出现周期性疼痛且疼痛源自腹部手术瘢痕或脐周肿物的女性，均应怀疑此病。
本报告旨在探讨子宫内膜异位症的诊断方法，并回顾单纯手术切除或联合激素治疗的治疗价值。
经切口活检确诊了脐下腹腔镜手术瘢痕处皮肤型子宫内膜异位症及剖宫产瘢痕处皮下型子宫内膜异位症。两种病变均先接受激素治疗，随后进行手术切除。
使用达那唑或亮丙瑞林进行激素治疗可减轻症状，但在两例中均导致闭经，在第二例患者中还导致性交困难。随后通过腹腔镜检查及手术切除子宫内膜瘤治愈。
术前激素治疗尽管有时会伴有闭经等副作用，但对于较大的子宫内膜肿物病例，可用于缩小手术缺损的大小，但手术切除仍是首选治疗方法。
