Rectus abdominis endometrioma after cesarean section

Case contributed by Dr Domenico Nicoletti

Presentation

Swelling and cyclic pain symptoms of a lump located in the abdominal wall with a previous history of cesarean section.

Patient Data

Age: 40 years
Gender: Female

Axial T1-weighted images with fat suppression, show dorsally to the aponeurosis of the right rectus oblique muscle, hyperintense cystic lesion for the bloody contents, with slightly high intensity in T1-weighted images. In STIR and T2-weighted images the lesion show hypointense signal. After contrast, it has no enhancement.

Histological report

Pathology

Adipose and fibrosclerotic tissue with endometriotic cystic nodule.

Case Discussion

Anterior abdominal wall endometriosis is defined as functional extraperitoneal endometrium. Scar endometriosis is the result from iatrogenic implantation of endometrium tissue during abdominal surgery. T1-weighted images with fat suppression show a homogeneous lesion with high signal intensity, indicating a hemorrhagic lesion of the abdominal wall.

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