Histological features in abdominal wall endometriosis

Abstract

Endometriosis is localization of endometrial tissue out of endometrium and myometrium. Location on peritoneum and scar tissue associated with abdominal incision called as abdominal wall endometriosis (AWE). Abdominal wall endometriosis is a rare lesion affection under 1% of effected patients. However, due to increase in laparoscopy, hysterectomy and cesarean section procedurs, the AWE cases are increasing. In this study we aim to analyse AWE rates and evaluate their histologic properties. Endometriosis cases between 2010-2015 were included in study. These cases were evaluated according to localization and out of these 23 cases were revealed as AWE, and in 15 of 23 cases histologic specimens can reach. 317 cases with endometriosis were revealed and 23 (7.2%) were identified as AWE. The mean age was 35±5 (29-45). In 11 (47.8%) cases AWE was developed on scar tissue which have a history of cesarean section procedurs in a mean 3.4 year before. In 10 (66%) cases tubal (ciliary) metaplasia, in 3 (20%) cases hobnail metaplasia and in one case (7%) atypia and mitosis were observed as glandular changes. In 11 (73%) cases myxoid changes, 3 (20%) signet ring-like cells-like changes, 2 (13%) atypical myocytes with giant cells, in one (7%) case thick walled vessels resemble spiral arteries of endometrium and in one case (7%) decidual changes were observed as stromal changes. In this study we highlight the high prevalence of AWE compare to literature. Besides, the wide spectrum of stromal and glandular metaplastic changes could be challenging in proper diagnosis. AWE should keep in mind in the differential diagnosis of lesions in this localization.