Korean J Obstet Gynecol.  2012 Apr;55(4):290-292. 10.5468/KJOG.2012.55.4.290.

A case of trocar site implantation of endometriosis three years after laparoscopic hysterectomy

• Lee HH
• Lim S
• Shin JW
• Park CY

• KMID: 1992629
• DOI: http://doi.org/10.5468/KJOG.2012.55.4.290

Abstract

We present the case of a 42-year-old woman who had undergone laparoscopic hysterectomy for uterine myoma three years prior to diagnosis with trocar site endometriosis. The patient was observed to suffer endometrial implant exclusively at the suprapubic trocar site. This case demonstrated that trocar site endometriosis can occur, even in a patient without a uterus and without previous endometriosis. The etiopathogenesis of this condition was likely attributed to the dissemination of endometrial tissue during laparoscopic surgery, resulting in subsequent microscopic endometriosis cell implantation in the trocar site.

Keyword

Endometriosis; Laparoscopy; Implantation

MeSH Terms

Adult
Endometriosis
Female
Humans
Hysterectomy
Laparoscopy
Myoma
Surgical Instruments
Uterus

Figure

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  Fig. 1 Transabdominal sonography reveals a hypoechoic mass in the suprapubic region.

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  Fig. 2 Endometrial stroma and gland structure of fibroadipose tissue (H&E, ×40).

Reference

1. Koger KE, Shatney CH, Hodge K, McClenathan JH. Surgical scar endometrioma. Surg Gynecol Obstet. 1993. 177:243–246.

2. Firilas A, Soi A, Max M. Abdominal incision endometriomas. Am Surg. 1994. 60:259–261.

3. Luisi S, Gabbanini M, Sollazzi S, Calonaci F, Razzi S, Petraglia F. Surgical scar endometriosis after Cesarean section: a case report. Gynecol Endocrinol. 2006. 22:284–285.

4. Gordon PH, Schottler JL, Balcos EG, Goldberg SM. Perianal endometrioma: report of five cases. Dis Colon Rectum. 1976. 19:260–265.

5. Wakefield SE, Hellen EA. Endometrioma of the trocar site after laparoscopy. Eur J Surg. 1996. 162:523–524.

6. Martínez-Serna T, Stalter KD, Filipi CJ, Tomonaga T. An unusual case of endometrial trocar site implantation. Surg Endosc. 1998. 12:992–994.

7. Murthy SM, Goldschmidt RA, Rao LN, Ammirati M, Buchmann T, Scanlon EF. The influence of surgical trauma on experimental metastasis. Cancer. 1989. 64:2035–2044.

8. Hubens G, Pauwels M, Hubens A, Vermeulen P, Van Marck E, Eyskens E. The influence of a pneumoperitoneum on the peritoneal implantation of free intraperitoneal colon cancer cells. Surg Endosc. 1996. 10:809–812.