Parietal Endometriosis After Cesarean Section: A Serie of Three Cases and Review of the Literature

Parietal endometriosis remains an uncommon diagnosis, with mechanisms of development that are still not fully elucidated. The most widespread hypothesis in its pathogenesis is the implantation of endometrial cells within musculoaponeurotic, cutaneous, or subcutaneous structures during operations, particularly hysterotomy. Parietal endometriosis follows typically gynecologic or obstetric surgery. Clinically, it typically presents as a discrete scar-related mass, tender at times, with a presentation that may change from one menstrual cycle to another — a presentation that can strongly lead to the diagnosis. Regardless of that, definite diagnosis is on histopathological examination, and surgical excision remains the gold standard of treatment. We report a series of three rare cases of parietal endometriosis arising in cesarean section scars, and on the basis of the case, we describe the hypothesized pathophysiological mechanisms, the classical clinical manifestations, the imaging role, the therapeutic options, and the clinical course, based on review of the literature.