Parasitic Myoma Identified 14 Years After Laparoscopic Myomectomy

Akihiro Takeda, MD, Shotaro Hayashi, MD, Sanae Imoto, MD, Hiromi Nakamura, MD

Department of Obstetrics and Gynecology, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan (all authors).

ABSTRACT

Introduction: Parasitic myoma after laparoscopic myomectomy with power morcellation is an emerging concern that has an iatrogenic aspect. However, the duration necessary for observation to identify parasitic myoma has not yet been clarified.

Case Description: A 47-year-old, gravida 2, para 2 woman was referred for an unusual pelvic mass. Her gynecological history was significant, with laparoscopic myomectomy with power morcellation for intraligamental myoma 14 years earlier. Uterine myoma, endometrial polyp, and suspicious parasitic myomas were diagnosed by magnetic resonance imaging. In a laparoscopic view, 4 parasitic myomas were identified. Single-port laparoscopic-assisted vaginal hysterectomy, bilateral salpingo-oophorectomy, and debulking of the parasitic myomas were performed. Histopathological examination demonstrated that the parasitic myomas were histologically similar to the myomas excised 14 years earlier.

Conclusion: Women who have already undergone myoma surgery with power morcellation should be followed up carefully for the potential development of parasitic myoma.

Key Words: Laparoscopic myomectomy, Magnetic resonance imaging, Parasitic myoma, Power morcellation.

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