An unusual case of large endometrioma within the rectus abdominis muscle misdiagnosed as desmoid tumour

Abstract

We describe an unusual case of giant intramuscular abdominal endometrioma clinically misdiagnosed as desmoid tumour
in a 36-year-old female patient with a one-year history of lower abdominal pain. Endometriosis is defined by the presence of endometrial tissue outside the uterine cavity, associated with fibrosis and inflammatory reaction. Although the
abdominal wall is one of the most frequent sites of extra pelvic endometriosis, the localization in the anterior rectus
abdominis muscle is unusual and associated with previous cesarean section. In most cases, the preoperative diagnosis is
erroneous because the different imaging modalities are nonspecific but only useful in determining the extent of disease
and in the planning of operative resection. A better acquaintance with the imaging presentation of abdominal wall
endometriosis holds the potential of positively impact disease confirmation and may play a crucial role in the face of
innovation in treatment.