Scar endometriosis - rectus abdominis muscle

Case contributed by Bouhouche Abdeldjalil
Diagnosis almost certain

Presentation

History of cesarean section, presenting with cyclic pain of the pelvic wall.

Patient Data

Age: 30 years
Gender: Female
  • ill-defined soft tissue mass in the right rectus abdominis muscle adhering deeply to the anterior uterine wall at the level of the cesarean section scar, showing isosignal to muscle on T1, inhomogeneous high signal on T2 with central areas of high signal on T1/T2 and T1 fat sat and intense enhancement after contrast administration

  • bilateral L5-S1 spondylolysis with mild anterolisthesis (grade I) and degenerative disc changes as well as secondary bilateral foramen stenosis in that segment

Case Discussion

Clinical presentation and MRI findings are most consistent with scar endometriosis.

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