LEUPROLIDE ACETATE IN THE MANAGEMENT OF CESAREAN SCAR ENDOMETRIOSIS

Background: Progestin or estrogen-progestin combination therapy has no t proven useful in the treatment of endometriosis of the abdominal sca r after cesarean delivery. We report our experience in managing this c ondition with a gonadotropin agonist. Case: A 22-year-old black woman with a history of two previous cesareans developed endometriosis of th e abdominal scar. The extent of the lesion was estimated by computed t omographic (CT) scan, and a 6-month preoperative course of leuprolide acetate was administered. The patient exhibited prompt symptomatic res ponse to the gonadotropin agonist, but the physical examination and CT scan findings were unchanged. Pathologic examination after surgical r emoval of the lesion confirmed the clinical diagnosis. Conclusion: Leu prolide acetate administered to a patient with cesarean scar endometri osis was associated with an improvement in symptoms, but there was no change in lesion size.