Endometriosis - rectus abdominis

Discussion:

Pathologically proven cesarean section scar endometrioma with full-thickness involvement of the anterior abdominal wall muscles.

Scar endometriosis can be easily overlooked on routine cross-sectional imaging. A previous cesarean section scar is one of the most common locations of endometriosis beyond the ovaries and uterus. 

The most plausible pathophysiological explanation is endometrial stem cell implantation at the surgical bed during uterine surgery. 

Scar endometriomas may show similar imaging features to pelvic endometriotic tissue on MRI, with high signal on fat-suppressed T1W images, representing ectopic endometrial glands. 

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