Abdominal wall mass suspected of endometriosis: clinical and pathologic features
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ObjectiveTo evaluate the clinical and pathological characteristics of lower anterior abdominal wall masses suspicious forendometriosis. MethodsA retrospective review of 38 patients who underwent surgery for a lower anterior abdominal wall mass suspicious forendometriosis was performed. Those with skin and intraperitoneal masses, lipomas, hernias, and metastatic malignantmasses were excluded. Patient age, body mass index, delivery history, dysmenorrhea, and mass size and location wereanalyzed. ResultsThirty-seven (97.3%) patients had a relevant surgical history, including 35 (92.1%) with a history of cesarean section(C/S). Among the three patients with no history of C/S, 1 underwent total abdominal and another total laparoscopichysterectomy, and 1 had no previous surgical history. The mean (±standard deviation) size of the abdominal masseswas 3.2±1.2 cm. One patient developed a recurrent mass after excision of abdominal wall endometriosis. Trocar siteendometrioma was found in one patient following total laparoscopic hysterectomy. According to the final pathologyreports, endometriosis was found in 35 (92.1%) of patients. The remaining 3 patients (7.9%) had malignancy:adenocarcinoma, squamous cell carcinoma, and extra-gastrointestinal stromal tumor. Before surgery, only 3 patients(7.9%) underwent fine-needle aspiration biopsy of the masses, which were all postoperatively confirmed to bepathologically benign. ConclusionAlthough most abdominal wall masses in the present sample were endometriosis occurring at the scar site from aprevious operation, 7.9% of patients ultimately exhibited malignancy. Therefore, all patients with suspected anteriorwall endometriosis should undergo preoperative biopsy to identify the few that will have an alternative diagnosis.
Abstract
ObjectiveTo evaluate the clinical and pathological characteristics of lower anterior abdominal wall masses suspicious forendometriosis. MethodsA retrospective review of 38 patients who underwent surgery for a lower anterior abdominal wall mass suspicious forendometriosis was performed. Those with skin and intraperitoneal masses, lipomas, hernias, and metastatic malignantmasses were excluded. Patient age, body mass index, delivery history, dysmenorrhea, and mass size and location wereanalyzed. ResultsThirty-seven (97.3%) patients had a relevant surgical history, including 35 (92.1%) with a history of cesarean section(C/S). Among the three patients with no history of C/S, 1 underwent total abdominal and another total laparoscopichysterectomy, and 1 had no previous surgical history. The mean (±standard deviation) size of the abdominal masseswas 3.2±1.2 cm. One patient developed a recurrent mass after excision of abdominal wall endometriosis. Trocar siteendometrioma was found in one patient following total laparoscopic hysterectomy. According to the final pathologyreports, endometriosis was found in 35 (92.1%) of patients. The remaining 3 patients (7.9%) had malignancy:adenocarcinoma, squamous cell carcinoma, and extra-gastrointestinal stromal tumor. Before surgery, only 3 patients(7.9%) underwent fine-needle aspiration biopsy of the masses, which were all postoperatively confirmed to bepathologically benign. ConclusionAlthough most abdominal wall masses in the present sample were endometriosis occurring at the scar site from aprevious operation, 7.9% of patients ultimately exhibited malignancy. Therefore, all patients with suspected anteriorwall endometriosis should undergo preoperative biopsy to identify the few that will have an alternative diagnosis.
참고문헌 (24)
- de Almeida Gentile J, "Malignant transformation of abdominal wall endometriosis to clear cell carcinoma : case report", Sao Paulo Med J, 136, pp.586~590 (2018)
- Rindos NB, "Diagnosis and management of abdominal wall endometriosis : a systematic review and clinical recommendations", Obstet Gynecol Surv, 72, pp.116~122 (2017)
- Blanco RG, "Abdominal wall endometriomas", Am J Surg, 185, pp.596~598 (2003)
- Taburiaux L, "Endometriosis-associated abdominal wall cancer : a poor prognosis?", Int J Gynecol Cancer, 25, pp.1633~1638 (2015)
- Shalin SC, "Clear cell adenocarcinoma arising from endometriosis in abdominal wall cesarean section scar : a case report and review of the literature", J Cutan Pathol, 39, pp.1035~1041 (2012)
- Modesitt SC, "Ovarian and extraovarian endometriosisassociated cancer", Obstet Gynecol, 100, pp.788~795 (2002)
- Ferrandina G, "Endometriosis-associated clear cell carcinoma arising in caesarean section scar : a case report and review of the literature", World J Surg Oncol, 14, pp.300~ (2016)
- Van Gorp T, "Endometriosis and the development of malignant tumours of the pelvis. A review of literature", Best Pract Res Clin Obstet Gynaecol, 18, pp.349~371 (2004)
- Emre A, "Laparoscopic trocar port site endometriosis : a case report and brief literature review", Int Surg, 97, pp.135~139 (2012)
- Siddiqui ZA, "Port site endometrioma : a rare cause of abdominal wall pain following laparoscopic surgery", BMJ Case Rep, 2017 (2017)
- Ozel L, "Abdominal wall endometriosis in the cesarean section surgical scar : a potential diagnostic pitfall", J Obstet Gynaecol Res, 38, pp.526~530 (2012)
- Patterson GK, "Abdominal wall endometriomas : report of eight cases", Am Surg, 65, pp.36~39 (1999)
- 김수미, "제왕절개술 후 복벽반흔에 발생한 자궁내막증 환자에서 mesh를 이용한 복부근막재건술 1예", Obstetrics & Gynecology Science, 55(07), pp.517~521 (2012), 대한산부인과학회[DOI]
- Purvis RS, "Cutaneous and subcutaneous endometriosis. Surgical and hormonal therapy", J Dermatol Surg Oncol, 20, pp.693~695 (1994)
- Alkhatib L, "Extragastrointestinal Stromal Tumor(EGIST)in the abdominal wall : case report and literature review", Int J Surg Case Rep, 2, pp.253~255 (2011)
- He X, "Extragastrointestinal stromal tumor of the abdominal subcutaneous tissue : report of a very rare case at an unusual site", J Int Med Res, 45, pp.1273~1278 (2017)
- Bektaş H, "Abdominal wall endometrioma; a 10-year experience and brief review of the literature", J Surg Res, 164, pp.e77~81 (2010)
- Horton JD, "Abdominal wall endometriosis : a surgeon's perspective and review of 445 cases", Am J Surg, 196, pp.207~212 (2008)
- Tatli F, "The clinical characteristics and surgical approach of scar endometriosis : a case series of 14women", Bosn J Basic Med Sci, 18, pp.275~278 (2018)
- Gidwaney R, "Endometriosis of abdominal and pelvic wall scars : multimodality imaging findings, pathologic correlation, and radiologic mimics", Radiographics, 32, pp.2031~2043 (2012)
- Medeiros F, "Fine-needle aspiration cytology of scar endometriosis : study of seven cases and literature review", Diagn Cytopathol, 39, pp.18~21 (2011)
- Grigore M, "Abdominal wall endometriosis : an update in clinical, imagistic features, and management options", Med Ultrason, 19, pp.430~437 (2017)
- Solak A, "Abdominal wall endometrioma : ultrasonographic features and correlation with clinical findings", Balkan Med J, 30, pp.155~160 (2013)
- Khan Z, "Risk factors, clinical presentation, and outcomes for abdominal wall endometriosis", J Minim Invasive Gynecol, 24, pp.478~484 (2017)