Serial Kasus : Presentasi Klinis dan Tata Laksana Nodul Endometriosis Subkutan

Shelly Franciska; Achmad Kemal  Harzif; Shindie Dona Kezia  Lethulur

doi:10.36452/jkdoktmeditek.v31i2.3479

Authors

Shelly Franciska Departemen Obstetri dan Ginekologi, Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Kristen Krida Wacana, Jakarta, Indonesia.
Achmad Kemal Harzif Divisi Imunoendokrinologi, Departement Obstetri dan Ginekologi, Universitas Indonesia, Jakarta, Indonesia
Shindie Dona Kezia Lethulur Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Kristen Krida Wacana, Jakarta, Indonesia

DOI:

https://doi.org/10.36452/jkdoktmeditek.v31i2.3479

Keywords:

cesarean section, subcutaneous endometriosis, surgical management

Abstract

Introduction: Subcutaneous endometriosis is a rare condition with
endometrial tissue localized outside the pelvis and often mimics general
endometriosis. The novelty of this study is an in-depth understanding of
the specific risk factors associated with subcutaneous endometriosis
after cesarean section and how optimal therapeutic approaches can
provide better outcomes in patients with a history of endometriosis. This
study aims to explore the clinical presentation, outcomes, and
managerial approaches to this condition, as well as provide evidencebased recommendations for its management. Case Illustration: This
study involved seven patients at Cipto Mangunkusumo Hospital (January
2022–December 2024). Data collected included demographics, age, BMI,
initial symptoms, time of symptom onset, history of cesarean section,
history of endometriosis, complications, nodule size, therapeutic
approaches, and clinical outcomes. Discussion: Of the seven patients,
three underwent one cesarean section, two underwent two operations,
and two underwent more than two cesarean sections. A history of diffuse
adenomyosis was found in three patients. Subcutaneous nodules located
mainly in the cesarean scar, had highly variable sizes and caused
significant pain (VAS 5–6). Dienogest therapy was given to three patients
and significantly reduced pain. Conclusion:Subcutaneous endometriosis
is often associated with a history of abdominal surgery, especially
cesarean section. Extrapelvic location can be mistaken for keloid or
fibroma, which hinders timely diagnosis. The novelty of this study lies in
emphasizing the importance of multidisciplinary collaboration in the
management of subcutaneous endometriosis, especially involving plastic
surgeons to improve aesthetic results and prevent recurrence.
Treatment involving hormonal therapy or surgery, based on the size and
location of the nodule, is essential for optimal results.

Author Biographies

Shelly Franciska, Departemen Obstetri dan Ginekologi, Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Kristen Krida Wacana, Jakarta, Indonesia.

Divisi Imunoendokrinologi, Departement Obstetri dan Ginekologi, Universitas Indonesia, Jakarta, Indonesia

Achmad Kemal Harzif, Divisi Imunoendokrinologi, Departement Obstetri dan Ginekologi, Universitas Indonesia, Jakarta, Indonesia

Divisi Imunoendokrinologi, Departement Obstetri dan Ginekologi, Universitas Indonesia, Jakarta, Indonesia

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