International Surgery Journal | July 2020 | Vol 7 | Issue 7 Page 2384 International Surgery Journal Sapiee ME et al. Int Surg J. 2020 Jul;7(7):2384-2388 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Case Report General surgeon’s experience in managing extra pelvic endometriosis Muhammad Eimaduddin Sapiee 1 *, Roziana Ramli 2 , Nor Syahaniza Waheeda Alias 2 , Zailani M. 1 , Ahmad Fazlin Nasaruddin 3 INTRODUCTION Endometriosis is an enigmatic disease managed almost exclusively by gynaecologists. Some patients however ended up being seen and managed by general surgeons, particularly those with extrapelvic endometriosis. Extrapelvic endometriosis which has been reported in nearly every organ system of the human female body, is less common than pelvic disease and is often difficult to diagnose and more difficult to treat. 1 When surgeons encounter endometriosis in their practice, their lack of experience sometimes leads to delay in diagnosis and suboptimal management. Therefore, it is important for surgeons to include endometriosis as one of the differential diagnosis in the management of their cases. We hereby report two unusual cases of extrapelvic endometriosis managed by the surgeons. CASE REPORT Case 1 A 35 years old lady was seen at the surgical outpatient clinic for a painful superficial abdominal mass. The mass was detected 1 year prior and has grown bigger with time. There was no association with bowel or urinary symptoms. The patient had a previous caesarean delivery but was otherwise well with no medical illness. Clinical examination showed a 3×3 cm firm, tender, and fixed mass in the subcutaneous fat of the left iliac fossa region. The rest of the abdomen examination was normal. The patient had an ultrasound (Figure 1) and computed tomography (CT) scan (Figure 2-4) done which confirmed a solid left subcutaneous tissue tumour. Due to ABSTRACT Two unusual cases of extrapelvic endometriosis are discussed here. Both presented themselves to the general surgeons. Case 1 presented with cyclical painful abdominal wall mass at the left iliac fossa region. Ultrasound and computed tomography scan showed a solitary mass at the subcutaneous region and fine needle aspiration cytology revealed endometriosis. The patient underwent wide surgical excision and recovered. Case 2 presented with painless swelling at the left inguinal area whilst being pregnant. Surgical exploration was performed for ‘left inguinal hernia’ but an encysted mass was found in the inguinal canal which was excised. Histopathological examination reported endometriosis. Both cases were subsequently under gynaecological follow-up. It is important for the surgeons to include endometriosis as one of the differential diagnosis in the management of their female patients with mass or swelling. Keywords: Extra pelvic endometriosis, Abdominal wall mass, Inguinal swelling 1 Department of Surgery, 2 Department of Obstetrics and Gynaecology, 3 Department of Pathology, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia Received: 20 April 2020 Revised: 21 May 2020 Accepted: 28 May 2020 *Correspondence: Dr. Muhammad Eimaduddin Sapiee, E-mail: eimad0307@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20202853