TITLE:
Abdominal Wall Endometriosis as Endometrioma-Cutaneous Fistula: A Case Report
AUTHORS:
Oluyemisi A. Adeyemi, Creighton L. Edwards, Thomas M. Wheeler, Shannon M. Hawkins
KEYWORDS:
Endometrioma, Fistula, Abdominal Wall Endometriosis, Surgical Management
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.4 No.14,
September
29,
2014
ABSTRACT: Endometriosis outside the pelvic cavity is rare,
but its most common extra-pelvic location is the abdominal wall, occurring most
frequently after cesarean delivery. Fistula tracks through these lesions in the
abdominal wall to the uterus are rare. However, a fistula between abdominal
wall endometriosis to an endometrioma has not been reported. A 46-year-old
multigravid woman presented with complaint of cyclical pain and bleeding from
her cesarean delivery scar and pelvic pressure. Computed tomography revealed a
complex, 16-cm left adnexal mass. Intraoperatively, a fistulous tract
connecting a large endometrioma in the abdominal-pelvic cavity to the skin was
noted and wide local excision of this track was performed in conjunction with
aggressive surgical management of endometriosis throughout the pelvis.
Pathologic analysis of the resected specimen confirmed the diagnosis. Although
rare, endometrioma-cutaneous fistula should be included in the differential
diagnosis of suspected abdominal wall endometriosis with concurrent adnexal
mass for appropriate surgical planning.