Abdominal wall reconstruction for a large caesarean scar endometrioma.

Endometrioma formation is an uncommon complication of caesarean sections. Frequently the diagnosis is delayed, due to a failure to include it in the differential diagnosis for an abdominal wall mass. The case of a thirty-six year-old female, presenting with the classical triad of a mass and cyclical pain arising in a caesarean section scar, is reported. Wide excision was performed via a transverse lower abdominal ellipse, similar to that used for abdominoplasty. The involved rectus muscle was excised and the abdominal wall was reconstructed using polypropylene mesh. An abdominoplasty-like approach affords clear margins for large caesarean section scar endometriomas thus reducing the recurrence risk. Abdominal wall reconstruction may be required for extensive lesions.