The occurrence of tumors resembling endometrial tissue in abdominal wounds has been reported infrequently. It is in these cases which appear to be the result of "seed implantation" of endometrial cells that the theory of direct transtubal dissemination of endometrium-like tumors throughout the pelvis has one of its strongest proofs.
The work of Sampson on the etiology of heterotopic endometrial tumors has brought forward many questions of fundamental importance. Acceptance of the transtubal dissemination theory has been general but recently objections have been raised (Novak, Ewing) which would seem to point out that tubal dissemination and implantation may account for only a relatively small percentage of the endometrial lesions of the female pelvis. These lesions occur in abdominal wounds. Heaney1 reported two cases and reviewed seven others following operative procedures on the pregnant uterus. In all, twenty-nine cases have been reported, and in several cases the uterus was not