事前の外科的介入のない、完全に遊離していた腹腔内遊離子宮筋腫の１例

抄録

　Extrauterine leiomyomas, often sustained by neovascularization from adjacent tissues and organs, are commonly termed “parasitic leiomyomas.” Presented herein is a rare case of a completely isolated uterine fibroid found within the pelvic cavity, devoid of any discernible nutrient connection with neighboring tissues.

Case: A 36-year-old gravida 3, para 3, woman presented at 32 weeks of gestation with a known uterine fibroid. Upon thorough ultrasound and clinical evaluation, a 5-cm mass on the right side of the uterus was discovered. Following a normal full-term vaginal delivery, the patient underwent ultrasonography and magnetic resonance imaging 28 months postpartum, revealing a well-defined pelvic mass on the left side of the uterus measuring 7-cm in diameter, consistent with leiomyoma. Laparoscopic intervention showed a shiny white mass around 7 cm in diameter, extending from the left adnexa to Douglas’ fossa. The mass was completely isolated and without any nutrient or vascular connection to surrounding organs. After morcellation, the mass was removed, and the histopathological examination confirmed the diagnosis of leiomyoma with hyalinization.

Conclusion: We reported a case of a completely isolated intraperitoneal uterine fibroid. Pedunculated uterine fibroids have been identified, and when their location or characteristics change after delivery, it is advisable to investigate for diseases such as isolated intraperitoneal uterine fibroids and parasitic leiomyomas.