Department of Surgery, New York Medical College, Westchester Medical Center, Valhalla, New York (all authors).

ABSTRACT

Introduction: Abdominal mesenteric cystic lymphangiomas are congenital lymphatic malformations found most commonly within the small bowel mesentery, omentum, and mesocolon. These lesions may be detected incidentally on imaging studies or may present with bowel obstruction. Treatment of choice is surgical enucleation with possible segmental intestinal resection.

Case Description: This report describes the use of minilaparoscopy in the treatment of abdominal mesenteric cystic lymphangioma (MCL) in a child, along with a review of the current literature on laparoscopic treatment. Our patient, who had a prenatal diagnosis of an intra-abdominal mass, had developed postprandial emesis. Imaging work-up with ultrasonography and CT scan revealed an intra-abdominal mass suspicious for lipomatous tumor. The patient underwent minilaparoscopy-assisted resection of the intra-abdominal mass, along with the resection of small bowel that was adherent to the tumor. The final pathology showed that the mass was an MCL.

Discussion: The traditional treatment for MCL has been open surgical resection. Recently, laparoscopic surgical excision of mesenteric cysts in children has been reported in the literature.

Key Words: Abdominal mesenteric cystic lymphangioma, Minilaparoscopy

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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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