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A Journal on Surgery

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Chirurgia 2010 December;23(6):267-9

language: English

Endometriosis of the rectus abdominis muscles diagnosed by fine needle aspiration cytology

Albayrak Y. 1, Guzel I.C. 2, Gelincik I. 3

¹ Department of General Surgery and Burn Unit Erzurum Region Education and Research Hospital, Erzurum, Turkey
2 Department of General Surgery, Erzurum Region Education and Research Hospital, Erzurum, Turkey
3 Department of Pathology, Erzurum Region Education and Research Hospital, Erzurum, Turkey


Abdominal wall endometriosis is rare, with an incidence of 0.03-0.47% following cesarean delivery. Frequently, its diagnosis is delayed due to a failure to include it in the differential diagnosis for an abdominal wall mass. The majority of patients have no prior history of endometriosis and symptoms may mimic postoperative hernias. Fine-needle aspiration cytology (FNAC) can be a valuable diagnostic aid in the evaluation of these subcutaneous abdominal masses. Endometriosis involving the rectus abdominis muscle is seldom encountered. We report two cases of endometriosis of the rectus abdominis muscle, presenting as a mass of the abdominal wall in women with a history of cesarean section. Fine needle aspirations were performed. The smears were highly cellular, showing a hemorrhagic background with hemosiderin-laden macrophages and sheets of epithelial cells. This cell pattern suggested a cytodiagnosis of endometriosis. The patients underwent surgical excision. These cases emphasize the need to include endometriosis in the differential diagnosis of palpable lesions of the abdominal wall, especially in women with healed surgical scars. The role of FNAC in diagnosing these types of lesions is also highlighted.

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