Endometrioma of the abdominal wall a general survey and case report

1.1. The history of ectopic endometrial tissue dates from the work of Cullen on uterine adenomyomas in 1895 to the papers of Sampson in 1921 and succeeding years.2.2. To date, misplaced endometrial tissue has been identified in fourteen different locations, principally pelvic.3.3. Of the various theories invoked to cover its origin, no one is applicable to all types; most notable are the menstrual regurgitation theory of Sampson, the theory of metaplasia of the pelvic peritoneum, the theory of developmentally misplaced Muellerian tissue, and the direct transplantation or seeding theory.4.4. The clinical symptoms vary according to the organ involved, with pain, particularly of a periodic type, almost constant, and the most characteristic finding is cystic cavities filled with thick, chocolate-colored blood.5.5. Diagnosis is seldom made until after operation, when the characteristic gross and microscopic findings lead to a repeated study of the history, in which the periodicity of the symptoms is elicited.6.6. Since these new growths are dependent upon the ovarian hormone for their development, surgical ablation of the ovaries is the logical course, although in young women conservatism is advised. The exact status of radium is not yet clear.7.7. In view of the many locations in which ectopic endometrial tissue has been identified, particularly the appendix and various portions of the intestines, it would seem incumbent upon the general surgeon as well as the gynecologist to acquaint himself with the pathology and management of the condition.8.8. A case is reported of endometrioma in the abdominal wall, following supravaginal hysterectomy.