抄録
Introduction: A parasitic myomas is defined as a pedunculated subserosal myoma, which is completely separate from the uterus, and receives its blood supply from other organs. The incidence of iatrogenic parasitic myomas has been increasing over the past decade; the cause is due to the implantation of excised uterine myoma fragments in the peritoneal cavity. We report a case of a parasitic myoma that developed after a laparoscopic myomectomy performed with an electric morcellator.
Case: A 47-year-old, gravida 0, who had a previous history of a laparoscopic myomectomy performed with an electric morcellator nine years ago, was referred to our hospital; her chief complaint was hypermenorrhea and she was found to have multiple myomas and a right ovarian cyst. Magnetic resonance imaging revealed a uterus comparable in size to that of a newborn head and multiple myomas. No other abnormal intraperitoneal masses were detected. She underwent a total abdominal hysterectomy and right salpingo-oophorectomy. Unexpectedly, four round and smooth masses, which were completely separate from uterus, were detected on the rectum and the sigmoid colon. The largest one (3 cm in diameter) was fed by small vessels from the sigmoid colon. These fibroid tumors were completely excised. Based on the intraoperative findings, parasitic myomas were suspected. The histopathologic findings confirmed leiomyomas.
Conclusions: We report a case of parasitic myomas that were discovered nine years after a laparoscopic myomectomy. Surgeons must be aware of the potential of development of iatrogenic parasitic myomas. Thus, meticulous attention should be paid to complete removal of fragments from excised myomas, especially after using an electric morcellator.
