A 37-year-old woman was detected with a painful lower abdominal nodular mass.
The lady had a history of an emergency cesarean section, 18 months ago, for preterm pregnancy with breech presentation in active labor. An inverted T incision was chosen due to the breech presentation and unformed lower uterine segment.
The postpartum recovery period was uneventful. However, 4 months post-surgery, the patient complained of pain on the left side of the incision site. She described the pain as constant and gave it a 3 out of 10 on the pain scale – on most days. Further, the pain doubled in intensity around her menses which was accompanied by a red-colored fluid emanating from the incision site.
On examinations, a non-mobile, nodular, moderately pigmented area of approximately 2×3 cm was detected at the left lateral border of the incision. A preliminary diagnosis of cutaneous endometrioma was considered.
The abdominal mass was resected and cutaneous endometriosis was confirmed. Histopathology depicted endometriosis involving fibro-adipose tissue with dense fibrous scarring. Molecular biology study revealed increased estrogen receptor expression, greater local growth factors, and staining with anti-CD 10.