Abdominal incision endometriomas.
General surgeons frequently are asked to evaluate masses appearing in abdominal incisions. The differential diagnosis of these masses is extensive, including suture granulomas, hernias, abscesses, and malignant tumors. When evaluating masses in or near cesarean section scars, endometrioma should also be considered in the differential diagnosis. The presence of endometriomas in and around cesarean section scars clearly has been established in the obstetrics/gynecology literature, with the reported incidence ranging from 0.03 to 0.4 per cent. However, the presence of only two case reports in the general surgery literature suggests underappreciation of this pathologic entity by general surgeons. It also indicates that endometrioma commonly may not be considered in the differential diagnosis of masses detected in or near cesarean scars. Cesarean scar endometriomas are diagnosed by clinical history, with surgical excision as the primary mode of therapy.