FNAC Diagnosis of Scar Endometriosis: A Report of 3 Cases with Review of Literature

Abstract

Endometriosis is defined as the presence of endometrial‑like glands and stroma outside the uterine endometrial lining. Endometrial tissue can be rarely identified on abdominal wall following numerous surgical or procedure scars, including cesarean section and hysterectomy. Cytological diagnosis of scar endometriosis is difficult, as it can be easily misinterpreted as benign spindle cells tumor. We report three cases where patients presented with a chief complaint of nodule in parietal abdominal wall adjacent to previous cesarean section scars and associated with history of cyclical pain. Provisional clinical diagnosis of desmoid tumor was made in one patient while the other two were diagnosed as endometriosis and they were referred for Fine needle aspiration cytology which revealed endometrial‑like epithelial cells, stromal cells and hemosiderin‑laden macrophages. Based on the cytological findings, diagnosis of Endometriosis arising in scar tissue was made which was confirmed on histopathology and wide local excision was done.