Implantation of endometriosis to pelvic and abdominal scar tissue is a very rare occurrence. Most commonly observed after cesarean sections due to implantation of uterine endometrial stem cells to outside tissues. Patients are often asymptomatic but may present with cyclic pain and mass. Imaging diagnosis is possible when classical implantation site near the scar tissue, clinical history and imaging findings are combined. In ultrasound imaging the lesion is often solid, mildly hypoechoic and often isoechoic to surrounding muscle. Presence of bleeding and fluid may cause the lesion to appear more heterogeneous. On computed tomography imaging the most pronounced finding is avid contrast enhancement of the lesion whereas in magnetic resonance imaging sensitivity to blood products.
Keywords: Endometriosis, anterior abdominal wall, scar endometriosis, diagnostic imaging