A case of spontaneous parasitic myoma in a patient without a history of myomectomy treated laparoscopically

Abstract

Parasitic myoma (PM) is a rare disease in which multiple leiomyomas are intraperitoneally formed. Recently, an increasing number of cases due to specimen morcellation during minimally invasive surgery has been reported. We present the first case of a PM identified intraoperatively during laparoscopic hysterectomy. A 40 -yearold Japanese multiparous woman presented to our hospital with heavy menstrual bleeding. She had no history of previous surgery. Magnetic resonance imaging showed uterine myomas. As the patient did not wish for further pregnancy, she underwent oral gonadotropinreleasing hormone antagonist therapy followed by a total laparoscopic hysterectomy. Intraoperatively, we identified a thumbsized tumor on the left side of the peritoneum. Histopathological examination showed evidence of benign leiomyoma.

A View on Uterine Leiomyoma Genesis through the Prism of Genetic, Epigenetic and Cellular Heterogeneity

“…Pathogenesis of benign metastasising (or parasitic) ULs is barely studied. There are assumptions that UL metastases might occur as a complication after laparoscopic surgery due to the morcellation of myomas and even that UL metastasising points towards the underestimated malignant potential of the initial tumour [ 229 , 230 , 231 , 232 ]. Regardless of UL metastasising mechanism, this phenomenon raises the need to update UL classification criteria as well as criteria to distinguish benign and malignant tumours.…”