Parasitic myoma - JSLS https://jsls.sls.org Journal of the Society of Laparoscopic & Robotic Surgeons Wed, 29 Jun 2016 14:56:07 +0000 en-US hourly 1 https://wordpress.org/?v=6.9.4 Parasitic Myoma Identified 14 Years After Laparoscopic Myomectomy https://jsls.sls.org/2015-00076/ Thu, 15 Oct 2015 12:00:42 +0000 https://crsls.sls.org/?p=1343 Akihiro Takeda, MD, Shotaro Hayashi, MD, Sanae Imoto, MD, Hiromi Nakamura, MD Department of Obstetrics and Gynecology, Gifu Prefectural Tajimi […]

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]]> 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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]]> Parasitic Myomas Due to Laparoscopic Intra-abdominal Morcellation https://jsls.sls.org/2013-00239/ Tue, 31 Mar 2015 12:02:12 +0000 https://crsls.sls.org/?p=1252 Giulia Giovanardi, MD, Stephane Oden, MD, Haitham Khalil, MD, Loic Marpeau, MD, PhD, Renato Seracchioli, MD, Horace Roman, MD, PhD Minimally […]

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]]> Giulia Giovanardi, MD, Stephane Oden, MD, Haitham Khalil, MD, Loic Marpeau, MD, PhD, Renato Seracchioli, MD, Horace Roman, MD, PhD

Minimally Invasive Gynaecological Surgery Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy (Drs. Giovanardi, Seracchioli). Department of Gynecology and Obstetrics, Rouen University Hospital, Rouen, France (Drs. Oden, Khalil, Marpeau, Roman).

ABSTRACT

Introduction: The use of electric tissue morcellators is crucial to allow the extraction of voluminous parts from a small laparoscopic incision, especially when the vagina is not opened. This report discusses how morcellation could be associated with the risk of intra-abdominal parasitic myomas developing.

Cases Description: Three women were affected by intra-abdominal parasitic myomas several years after laparoscopic hysterectomy or myomectomy with specimen extraction by morcellation. The myomas were discovered either by accident (case 3) or because the patients were symptomatic (cases 1 and 2). The symptoms are usually unspecific.

Discussion: The use of a morcellator may be associated with the risk of disseminated myoma fragments during the procedure and the rare development of complications from parasitic myomas. Meticulously inspecting the abdominal cavity at the end of the procedure and assessing the size of the uterus and fibroids before the procedure can reduce this risk. It is very likely that these cases are underestimated because patients may be asymptomatic and these parasitic myomas can occur years after the operation.

Key Words: Myoma, Parasitic myoma, Morcellation, Myomectomy, Laparoscopic hysterectomy.

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