Endometriosis is found in 15% of reproductive age women and 1% of patients have cutaneous manifestations. The pathogenesis of the disease is not entirely clear. The prevailing theory suggests that endometrial cells are “seeded” into the postoperative or, in case of umbilical endometriosis, into the physiologic scar. Other theories consider cutaneous endometriosis is a result of pluripotent celomic cell proliferation or hematogenous and lymphatic spread of endometrial cells. Currently known cellular and molecular interactions cannot prove any theory right. This case report demonstrates the clinical manifestations and management strategies of cutaneous endometriosis. A 34-year patient (2g1p) referred to a gynecologist with profuse and painful menses, pain and swelling at the site of a cesarean section scar for 6 months. The patient’s first pregnancy ended up with silent miscarriage and the second one with cesarean section at 38 weeks due to pre-eclampsia. Later, the patient had dyspareunia and secondary infertility. Upon gynecological exam, the patient had a single focus of endometriosis in the cervix, a ball-shaped uterus with limited displaceability, and uterosacral ligament infiltration. To the left of the cesarean section scar, there was a 3 cm painful and slightly displaceable lump. It was excised, and approximately 20 ml of hemorrhagic fluid flew out. A histological investigation of the lump revealed endometrioid infiltration. After the lump removal, the patient takes 2 milligrams of dienogest daily and the follow-up is continued. Since the patient had cervical endometriosis, adenomyosis, and a cesarean section, our case can support the "seeding" theory. However, the further research should determine the exact mechanisms of postoperative cutaneous endometriosis.

ESDR171 - A case of cesarean section scar endometriosis

The scientific meeting of the European Society for Dermatological Research (ESDR) is held yearly, usually in September. With an international attendance of more than 1000 skin scientists from around the globe, the four-day event includes short oral presentations from peer-reviewed abstracts, keynote lectures from international experts, sponsored symposia, satellite programs, educational events as well as an important focus on posters, networking and building collaborations amongst scientists. For more information about this year’s meeting visit our website.