<![CDATA[Introduction: Cutaneous endometriosis is a rare form of extragenital endometriosis characterized by the presence of endometrial tissue within the skin, most commonly associated with previous gynecologic or obstetric surgical scars, particularly cesarean section. The diagnosis is often challenging due to nonspecific clinical manifestations and variable symptomatology. Case Presentation: A 31-year-old woman, gravida 2 para 1, with a history of cesarean section 14 years prior, underwent a repeat cesarean section for the same indication of cephalopelvic disproportion. During the second pregnancy, the patient did not report any palpable abdominal mass or menstrual abnormalities, except for mild dysmenorrhea. Intraoperatively, a well-defined mass was incidentally identified within the subcutaneous fat layer, firmly attached to the fascia, measuring 4.7 × 2.9 × 2.7 cm. The mass appeared yellowish with partially brownish areas and had a firm–elastic consistency. Complete surgical excision was performed. Histopathological examination revealed adipose and connective tissue containing nodular aggregates of decidualized cells, with no evidence of malignancy. Postpartum follow-up for three months showed complete resolution of symptoms without recurrence. Conclusion: Cutaneous endometriosis may present as an incidental intraoperative finding and can remain asymptomatic, particularly during pregnancy due to decidualization. A prior history of cesarean section is a significant risk factor. Complete surgical excision remains the treatment of choice and is associated with excellent clinical outcomes. Increased awareness of this rare entity is essential to ensure accurate diagnosis and appropriate management.]]>
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