Presentation
Cyclic painful nodule of the pelvic wall. History of two previous cesarean sections.
Patient Data
There is an ill-defined subcutaneous soft tissue mass of the pelvic wall at the right lateral aspect of the previous C-section scar measuring 35 x 23 x 12 mm, invading the external oblique muscle. It displays an isosignal to the muscle on T1 and T2 with enhancement on the postcontrast sequences.
Elongated uterus adherent of the posterior pelvic wall at the level of the surgical scar.
Normal appearance of both ovaries showing small follicles.
Case Discussion
MRI features of scar endometriosis.
Scar endometriosis occurs in a cesarian section scar. It can be located in the skin, subcutaneous tissue, rectus muscle/sheath, as well as intraperitoneally, or within the uterine scar. The reported incidence of scar endometriosis following cesarean section is about 0.03-0.6%.