CASE 291: ABDOMINAL PAIN POST CESAREAN, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Woman  34 yo, very painful some days during menstrual cycle for 2 years ago and after  cesarean operation  3 years before. Pain at  10cm  upper  pubis   near middle line and clinical palpation detected  one  mass of round shape and pain  at pressure.
Ultrasound  scan detected this mass ellypsoid, size 4cm x 3 cm intra right  rectus abdominus  muscle.
With  probe  3.5 MHz  this  mass was hypoechoic pattern looked like a cyst,  with  a small artery inside (see image 1, and video).

With linear probe 15MHz  this mass  had inhomogeneous structure, central  necrosis. Elastoscan this mass was  soft at central part (see  image 3 and 4).

FNAC was done for diagnosing the mass. Result from pathologist was hematoma with cells that were suspected endometrium cells.

What are your guidings for treatment for the patient?