Malignant transformation of abdominal wall endometriosis with lymph node metastasis: Case report and review of literature

IntroductionEndometriosis is defined as the emergence and growth of endome-trial tissue (glands and stroma) outside of the uterus. It affects 8–15%ofthepopulationandismostfrequentlyfoundintheovary.Extrapelvicimplantationmayoccurinanyorganortissue,butisrareintheabdom-inal wall. When it does occur there, a history of surgery, whetherlaparotomy or laparoscopy, is usually present.Malignancy of this type of endometriosis in an abdominal wall scarmay occur from just a few months until up to 18 years after surgery(Hensen et al., 2006). The case we discuss below deals with themalignant transformation of cesarean scar endometriosis with nodalmetastasis at preperitoneal level. This is interesting because no otherknown cases have ever been reported.Case presentationWehereinpresentthecaseofa49 year-oldpatientwithahistoryofappendectomy, two births, a cesarean section, and removal of theendometriotic mass in the cesarean scar, 15 years before.