Some of you may have read my previous blog about Cesarean scars and Endometriosis.  In the studies referenced in that blog entry, all of the women complained of bumps or lumps or pain in their c-section scars.  Turns out they had developed Endometriosis in their scar tissue; likely the cells were transferred during the surgical procedure.

But…correspondence published just a few days ago references a woman who was found to have Endometriosis growing within the fascia of her abdominal wall nearly 1.25 inches above her scar line.  She was 41-years-old and had complaints of the bump for the past 3 years.  It didn’t bug her; she had no symptoms.  It wasn’t discolored…it was just a mass.  A bump.  A lump…that just sat there.  She had previously undergone two c-sections (one seven years ago and one 10 years ago).  An ultrasound classified the lump as a cyst, nearly 32 x 23mm (1″ x 1.25″) in size and doppler scanning showed it had a blood flow.  So, a biopsy was taken, which revealed it was an Endometriosis mass.  It was excised and hadn’t come back within six months.  But it was, in fact, confirmed as Endometriosis.

The authors hope that this leads healthcare workers to consider the possibility that masses outside of abdominal scarring may be Endometriosis.  They’re not just limited to appearing within surgical scars.  The mass needs to be biopsied and handled accordingly.  If you’d like to read the study, it’s linked below.

Subsequent to the writing of this original blog post, I learned of another episode of abdominal wall Endometriosis (so I’m updating it here).  A 36-year-old woman who had no medical history except for a c-section complained of a lump (that didn’t hurt at all) on the left side of her lower abdomen.  An ultrasound found thickening of the abdominal muscle in that spot and an MRI was able to confirm that this thickening was a lesion which gave signs of bleeding.  Her doctor suspected abdominal wall Endometriosis and excised the mass.

A recent April 2018 study was published about a 36-year-old woman who complained of a pain along her appendectomy scar.  She had her appendix removed previously and pain had begun along her scar line two years ago. It continued to worsen until she found herself in the ER because of the severity of the pain.  A CT scan identified a mass withiin her abdominal wall.  Surgery was performed, the lump was excised (along with nearby “chocolate shaped secretion areas” which were located between internal muscles), and a biopsy confirmed the lump was Endometriosis.  Appendectomy scar Endometriosis may be incredibly difficult to diagnose without surgery.

Got a bump in or around your c-section scar?  Talk to your doctor!  Haven’t had a c-section, but still have a lump or bump?  You should still go talk to your doctor.

*Updated May 24, 2018*

Resources:

Clinical & Experimental Dermatology – (Abstract; Jan. 2017) Development of Abdominal Wall Endometriosis in a Region Distant from a Cesarean Scar (full article no longer available online)

Journal of Clinical Urology (May 2017; Article) Abdominal Wall Endometriosis

Middle East J Dig Dis (April 2018; Article) Appendectomy Scar Endometriosis: A Case Report

~ Again, I am a layman.  I do not hold any college degrees, nor mastery of knowledge.  Please take what I say with a grain of salt.  If curious, do your own research Validate my writings.  Or challenge them.  And ALWAYS feel free to consult with your physician. Always.  Yours ~ Lisa