Reliable clinical and sonographic findings in the diagnosis of abdominal wall endometriosis near cesarean section scar

Figure 4 A 35-year-old woman with 52-mo of cyclic pain (after a cesarean delivery 2 years previously) that was not relieved by a surgical intervention for “intestinal adhesions” performed 44 mo before admission. A: US displays a huge (widest diameter: 60 mm), heterogeneous, irregularly-shaped mass occupying (between white arrows) the entire abdominal subcutaneous fat thickness and infiltrating the underlying muscle; B: A cystic area is seen along the posterior aspect of the mass (arrow); C: Cut surface of the surgical specimen: note the irregular shape of the highly vascularised mass with margins infiltrating adjacent tissues, the huge amount of white fibrotic strands and the multiple, well-defined haemorrhagic cystic collections (black arrows point out the greatest collections).