Abstract
Introduction: Laparoscopic myomectomy has been introduced as a new modality for the treatment of uterine leiomyoma, and one of the advances in laparoscopic technology is the development of electronic morcellators. Morcellation instruments are widely used to remove large myomas through small abdominal incision sites. However, recent evidence suggests that the use of morcellation devices may be a significant risk factor for the development of parasitic myomas. Parasitic myomas can be divided into two categories: iatrogenic parasitic myomas and non-iatrogenic parasitic myomas. The latter are known to be extremely rare. Here, we report a case of possible aberrant implantation and growth of uterine leiomyoma tissue in the abdominal cavity.
Case: A 46-year-old Japanese woman who was referred to us without a previous history of abdominal surgery underwent laparoscopic left salpingo-oophorectomy and right ovarian cystectomy. During the survey of the entire abdomen, 2 peculiar masses were found. One was attached to the left ovary and the other was located on the right round ligament. Histological diagnosis confirmed that these lesions were compatible with uterine leiomyoma.
Conclusion: Iatrogenic parasitic myomas are believed to originate from fragments of uterine tissue that are left in the peritoneal cavity after morcellation. Missed fragments can implant in the abdominal cavity and abdominal wall after neovascularization. The theoretical pathologic basis of non-iatrogenic parasitic myomas is suspected to be the attachment and subsequent growth of subserous myomas that twist from their uterine pedicles. This rare case strongly reinforces the theory that pedunculated subserous myomas can implant and grow in the abdominal cavity.
