© P o l s k i e T o w a r z y s t w o G i n e k o l o g i c z n e Nr 08/2013
726
Ginekol Pol. 2013, 84, 726-729
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położnictwo
Giant recurrent perineal endometriosis in an episiotomy scar – a case report
Olbrzymia nawrotowa endometrioza w bliźnie po nacięciu krocza – opis przypadku
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¹ I st Department of Obstetric and Gynecology Medical University of Warsaw, Poland
² Department of General Surgery and Transplantology, Transplantation Institute, Medical University of Warsaw, Poland.
Abstract
The occurrence of perineal endometriotic lesions can be explained by mechanical dissemination and transplanta- tion of endometrial cells. Viable decidual endometrial cells are likely to be transplanted into the episiotomy wounds or perineal tears during normal vaginal delivery and subsequent growth may occur. A case of a 33-year old woman with a medical history of recurrent perineal endometriosis was described. An endometriotic giant mass (8 centime- ter in diameter) was wide-excised, together with the episiotomy scar. The recovery was uneventful. Three years after the surgery, the patient is symptom-free and with no signs of recurrence or discomfort.
According to the literature and our own experience, a complete excision of endometriotic tissue is the treatment of choice. We can conclude that a wide excision is mandatory as it is the only way to prevent tumor recurrence.
Key words: HQGRPHWULRVLV/ SHULQHXP / HSLVLRWRP\ VFDU /
Streszczenie
Zmiany endometrialne w obrębie blizny po nacięciu krocza powstają najprawdopodobniej w wyniku transplantacji komórek błony śluzowej macicy, podczas porodu drogą pochwową. W pracy opisano przypadek pacjentki z na- wracającą endometriozą w bliźnie po nacięciu krocza. Duży guz o średnicy 8 cm został w całości usunięty chirur- gicznie wraz z blizną po nacięciu krocza. Przebieg gojenia był niepowikłany. 3 lata od operacji pacjentka pozostaje asymptomatyczna, bez żadnych dolegliwości. Leczeniem z wyboru w przypadku endometriozy krocza jest szerokie wycięcie guza z marginesem tkanek zdrowych.
Radykalne wycięcie zmiany daje szansę na brak nawrotów. Jest ono również istotne ze względu na przypadki przemiany nowotworowej w obrębie podobnych zmian.
Słowa kluczowe: HQGRPHWULR]D / NURF]H / EOL]QD SR QDFLĊFLX NURF]D /
Otrzymano: 12.12.2012
Zaakceptowano do druku: 10.06.2013 Adres do korespondencji:
Katarzyna Luterek
I st Department of Obstetric and Gynecology Medical University of Warsaw Poland, 02-015 Warszawa, Pl.Starynkiewicza 1/3
tel: +48 22 502 14 60; fax: +48 22 502 21 57 e-mail: katarzyna.luterek@wum.edu.pl
© P o l s k i e T o w a r z y s t w o G i n e k o l o g i c z n e
Nr 08/2013
727
P R A C E K A Z U I S T Y C Z N E położnictwo Ginekol Pol. 2013, 84, 726-729
Katarzyna Luterek et al. Giant recurrent perineal endometriosis in an episiotomy scar – a case report.
Introduction
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Picture 1. Wide excision with a margin of healthy tissue.
Picture 2. Multilayer sutures on the lodge.
© P o l s k i e T o w a r z y s t w o G i n e k o l o g i c z n e Nr 08/2013
728
położnictwo
P R A C E K A Z U I S T Y C Z N E Ginekol Pol. 2013, 84, 726-729
Katarzyna Luterek et al. Giant recurrent perineal endometriosis in an episiotomy scar – a case report.
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© P o l s k i e T o w a r z y s t w o G i n e k o l o g i c z n e
Nr 08/2013
729
P R A C E K A Z U I S T Y C Z N E położnictwo Ginekol Pol. 2013, 84, 726-729
Katarzyna Luterek et al. Giant recurrent perineal endometriosis in an episiotomy scar – a case report.
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