Parasitic Leiomyomas Following Laparoscopic Myomectomy

Nisse V. Clark, MD, Mateo G. Leon, MD, Colleen M. Feltmate, MD, Sarah L. Cohen, MD

Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, Massachusetts (Drs. Clark, Feltmate, and Cohen).
Department of Obstetrics and Gynecology, University of Texas Health-McGovern Medical School, Houston, Texas (Dr. Leon).

ABSTRACT

Introduction: Parasitic leiomyoma is a rare condition that may be spontaneous or iatrogenic in origin. Laparoscopic uterine surgery and tissue morcellation are procedures that may lead to the development of parasitic leiomyoma.

Case Description: We report the case of a 36-year-old woman with a history of a laparoscopic myomectomy and uncontained power morcellation who presented to our institution 6 years later with 2 large parasitic fibroids together weighing over 1 kg. We additionally present a review of the literature on development of parasitic leiomyoma after myomectomy, summarizing 35 published cases in addition to our own.

Conclusion: Parasitic leiomyoma is estimated to occur after 0.20 to 1.25% of laparoscopic myomectomies, and is diverse in it’s presenting symptoms and surgical findings. Tissue morcellation is suspected to be a risk factor in the development of this condition.

Key Words: Parasitic leiomyomas, Myomectomy, Uncontained morcellation.

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