Cases of abdominal wall endometriosis distinguished from soft tissue tumors: A report of three cases

Endometriosis is an estrogen-dependent inflammatory disease characterized by the presence of endometrium-like tissue in sites outside the uterine cavity. It affects 6-10% of women of reproductive age. Concerning abdominal wall endometriosis, it is particularly rare with a reported incidence of 0.03-3.5%. Abdominal wall endometriosis may be misdiagnosed as soft tissue tumors. Patients are often referred to an orthopedic department, although this is not familiar to orthopedic surgeons. In the present report, we describe three women with abdominal painful mass who had previously undergone Caesarean section. The masses were associated with their menstrual cycle and existed proximal to the Caesarean section surgical scar. Pelvic magnetic resonance imaging revealed isointense or hyperintense to muscle on both T1- and T2-weighted images. All patients were suspected of suffering from abdominal wall endometriosis, and were treated with complete surgical resection and developed no recurrence. The pathological findings confirmed endometrial gland and endometrial stroma features. Clinical symptoms and medical history play an important role in the diagnosis of abdominal wall endometriosis in addition to radiological examinations.