Abdominal wall endometrioma mimicking an incarcerated hernia: a case report

Christos Simoglou,¹ Paul Zarogoulidis,² Nikolaos Machairiotis,³ Konstantinos Porpodis,² Lambros Simoglou,⁴ Alexandros Mitrakas,⁵ Agisilaos Esebidis,⁵ Eirini Sarika,⁶ George Kouklakis,⁷ Alkis Iordanidis,⁸ Nikolaos Katsikogiannis<sup>3

1</sup>Cardiothoracic Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece; ²Pulmonary Department, "G Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Greece; ³Surgery Department (NHS), University General Hospital of Alexandroupolis, Greece; ⁴Surgical Clinic (NHS), Komotini General Hospital, Thrace, Greece; ⁵1st University Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece; ⁶Biopathology Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece; ⁷Gastrointestinal Endoscopy Unit, University General Hospital of Alexandroupolis, Democritus University of Thrace, ⁸Radiology Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece

Abstract: The case of a tender, isolated abdominal wall tumor within a Pfannenstiel incision due to a seeding deposit of endometrial tissue secondary to a previous obstetric operation (caesarean section) in a 39-year-old female without previously reported pelvic endometriosis is presented. The lesion clinically mimicked the appearance of an incarcerated incisional hernia at the outer corner of the healed Pfannenstiel incision. The preoperative differential diagnosis also included that of a locally forming post-operative tender granuloma and the remote possibility of an incisional endometrioma (although no link to menstruation could be made). Local malignancy was not taken as a serious possibility. Definitive diagnosis of the excised lesion was made at histology. The pre-operative diagnostic dilemma is presented, along with a short review of the literature.

Keywords: endometrioma, seeding endometriosis, abdominal wall tumor