Rectus Abdominis Endometriosis Following Cesarean Section: A Case Report

TL;DR

A 42-year-old woman with a history of cesarean sections developed rare rectus abdominis endometriosis, confirmed by biopsy and successfully treated with surgery.

Contribution

This case report highlights the rare occurrence of rectus abdominis endometriosis following cesarean sections and its successful management.

Findings

Endometrial glands and stroma were confirmed via biopsy in the rectus abdominis muscle.

The patient remained recurrence-free for two years after wide excision of the lesion.

The lesion was located near a previous Pfannenstiel incision, suggesting surgical origin.

Abstract

Endometriosis involves the growth of endometrial-like tissue outside the uterine cavity, with its manifestation in the rectus abdominis muscle being exceptionally rare and primarily observed in women with a history of abdominal surgeries. In this report, we present the case of a 42-year-old female with a medical history of two cesarean sections who presented with cyclical abdominal pain and a palpable mass in the right lower quadrant. An MRI scan of the pelvis revealed a lesion on the right lower quadrant of the abdominal wall, proximate to the previous Pfannenstiel incision. A percutaneous US-guided biopsy of the abdominal lesion was performed, and histopathology demonstrated the presence of endometrial glands and stroma, confirming the diagnosis of rectus abdominis endometriosis. She was submitted to a local wide excision with adequate margins of normal surrounding tissue and has remained free of recurrence for two years.

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