Scar endometriosis at site of cesarean section and umbilicus

Scar endometriosis is a rare condition. We report a case of scar endometriosis occurring at the site of an old cesarean section scar and umbilicus. Case report: A 40-year-old multiparous woman complained of painful sensation during menstruation for 2 years that occurred at the site of her midline cesarean section surgical scar. Blood discharge with pain and redness at umbilical and scar wound site for 3 months. On examination, there was a firm hyperpigmented nodule measuring 3 x 3 cm in size at the upper site of the midline scar. In view of the possibility of scar endometriosis, the mass was widely excised. Pathologic findings were compatible with scar endometriosis. Postoperatively, tab dinogest (2mg) once daily was prescribed to prevent recurrence. Conclusion: A surgical scar becoming painful and swollen during menstruation is the classic symptom of scar endometriosis. Causes include iatrogenic transplantation of endometrium to the surgical wound. Surgical excision is the main treatment. Postoperative GnRH-agonist or danazol or dinogest may be prescribed to patients with scar endometriosis.