Rectus Abdominis Endometriosis. A Descriptive Analysis of 10 Cases Concerning This Rare Occurrence

Objective: To report 10 cases of rectus abdominis endometrioma, emphasizing the clinical presentations, imaging investigations, cytohistological findings, and surgical treatment employed.

Methods: This is a descriptive analysis of 10 surgically-proven cases of rectus abdominis muscle endometriosis, seen over a 5-year period from 2007 to 2012 at Sohag University Hospital, Sohag, Egypt and Najran Armed Forces Hospital, Najran, Saudi Arabia. All patients had undergone ultrasonography. Computerized tomography (CT) and magnetic resonance imaging (MRI) were performed in some cases. Surgical excision was the way of treatment in all patients.

Results: This study was carried out in 10 women with a mean age of 33.9 years. Nine cases had previous history of cesarean section (CS) while one patient had laparoscopy converted to laparotomy for ovarian cyst. All patients were presented with abdominal pain but only 3 had a palpable mass. Ten lesions within the rectus abdominis muscle were detected with automated ultrasound and MRI depicted one lesion, which was missed by ultrasound in a patient who had 2 concomitant lesions. Preoperative fine needle aspiration (FNA) was carried out in 2 patients. Wide surgical excision was performed in all cases. Histopathology was confirmatory in each instance. No complications or recurrence were recorded on follow-up (6-24 months; mean 13.2 months).

Conclusion: This disease is not as rare as previously thought, and should be included in the differential diagnosis of abdominal wall masses in reproductive-age females.