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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Department of Gynecological Endoscopy and Anatomopathology, Nuova Villa Claudia Hospital, Rome, Italy (Drs. Sizzi, Rossetti, Soda, Pellegrino). Department of Radiological Oncological and Anatomopathological Sciences, Umberto I Hospital, Sapienza University of Rome, Rome, Italy (Drs. Saldari, Manganaro).

ABSTRACT

Experience with minimally invasive approaches, such as laparoscopic ablation and transanal endoscopic microsurgery, to resection pelvic retroperitoneal and presacral tumors is limited. Masses arising from this anatomic position are usually removed using a transsacral approach or laparotomy. We report a detailed description of the laparoscopic procedure performed in a 32-year-old woman to remove a mass, which was detected with both ultrasonography and magnetic resonance imaging, that was closely adherent to the left sacrospinous ligament and compressing the rectum. Histopathologic findings were consistent with a rare case of pelvic retroperitoneal epidermoid cyst. This tumor, which usually occurs in the face, the scalp, the trunk, or the neck, has been described in the pelvic retroperitoneal space in only a few cases.

Key Words: Epidermoid cyst, Laparoscopy, Magnetic resonance imaging, Retroperitoneal cysts.

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