Parasitic leiomyoma causing small bowel perforation: A case report

Parasitic Myoma: A Rare Complication of Laparoscopic Myomectomy

The occurrence of a parasitic myoma is an unusual condition and it is traditionally thought to be a variant of pedunculated subserosal myoma that has become separated from the uterus and received alternative blood supply. However, the prevalence of laparoscopic surgery might have brought a new type of parasitic myoma named iatrogenic parasitic myoma. This type of parasitic myoma raises the question of whether it should be considered as a long-term complication of laparoscopic myomectomy. This report aims to present a case of parasitic myoma in a 38-year-old woman who underwent laparoscopic myomectomy using a morcellator. Due to the prevalence of laparoscopic myomectomies and the risk of spreading unsuspected leiomyosarcoma with morcellation, this case highlights the need for in-bag containment morcellation to extract specimens. At the same time, a careful inspection and washing of the abdominopelvic cavity at the end of the surgery should be performed to minimize the complication of open power morcellation.

Parasitic leiomyoma of the greater omentum: a case report and literature review

Parasitic leiomyomas (PL), also known as free leiomyomas, which occur outside the uterus and rarely happen in clinical practice. They are usually reported in women of reproductive age who underwent hysterectomy or myomectomy and frequently present with symptoms such as abdominal pain and distention. In fact, it is hard to determine the nature of the mass according to the imaging examination and clinical manifestation. At present, the most common treatment involves an abdominal or laparoscopic surgery in order to remove the mass and perform the next step of treatment based on the histological diagnosis. In this case report, we describe a 35-year-old woman with a 12.4 × 9.3 × 9.8 cm3 PL with blood supply from the greater omentum. Considering the prolonged menstruation of the patient, she underwent the hysteroscopic and laparotomy exploration. The mass was confirmed as smooth leiomyoma with necrosis by the immunohistochemical examination. The patient had a good recovery and being discharged seven days after the surgery. The patient is still in the follow-up.

Parasitic myoma after transabdominal hysterectomy for fibroids: a case report

BACKGROUND

Parasitic myomas typically occur after a pedunculated subserosal fibroid loses its uterine blood supply and parasitizes other organs or after a surgery involving morcellation techniques. Parasitic myomas that occur after transabdominal surgery are extremely rare and may not be sufficiently documented. Here, we present a case of parasitic myoma in the anterior abdominal wall following a transabdominal hysterectomy for fibroids.

CASE PRESENTATION

The patient was a 46-year-old Chinese woman who had undergone surgery for uterine myomas at our hospital 1 year prior. The patient later revisited our department with a palpable mass in her abdomen, and imaging revealed a mass in the iliac fossa. The possibility of a broad ligament myoma or solid ovarian tumor was considered before surgery, and laparoscopic exploration was performed under general anesthesia. A tumor measuring approximately 4.5 × 4.0 cm was found in the right anterior abdominal wall, and a parasitic myoma was considered. The tumor was completely resected. Pathological analysis of the surgical specimens suggested leiomyoma. The patient recovered well and was discharged on postoperative day 3.

CONCLUSION

This case suggests that parasitic myoma should be considered in the differential diagnosis of patients presenting with abdominal or pelvic solid tumors with a history of surgery for uterine leiomyomas, even without a history of laparoscopic surgery using a power morcellator. Thorough inspection and washing of the abdominopelvic cavity at the end of surgery is vital.