Incisional endometriosis: a report of 3 cases.

E ndometriosis is defined as a growth of ectopic endometrial tissue outside the uterine cavity that responds to hormonal stimulation. It occurs most commonly in pelvic sites such as the ovaries, posterior cul-de-sac, ligaments of the uterus, pelvic peritoneum and rectovaginal septum and is found in 8%–15% of all menstruating women. Extrapelvic endometriosis is less common but can affect many sites, including the lungs, appendix, nose, umblicus, peritoneum and even the intestinal wall. The most common extrapelvic form of endometriosis is cutaneous endometriosis, mainly in scars following obstetric or gynecologic surgery. Surgical scar endometriosis following cesarean section has an incidence of 0.03%–0.4%. Because it is often mistaken for a suture granuloma, incisional hernia, lipoma, abscess, cyst or a strange body, diagnosis of this disease is not easy. However, a mass in a cesarean section scar with symptoms of cyclic pain related to menses is nearly pathognomonic. We report the cases of 3 women, aged 32, 22 and 30 years, respectively, who presented with a painful abdominal wall mass.