A case of spontaneous parasitic leiomyoma with torsion diagnosed by laparoscopy

Abstract

Parasitic leiomyoma is a rare manifestation of uterine leiomyoma that loses its adherence to the uterus to attach to other pelvic or intra-abdominal organs. Most reported tumors presented during laparoscopic myomectomy or hysterectomy.We report here a case of spontaneous parasitic leiomyoma with torsion in a 30-year-old woman with no previous surgeries. She was diagnosed with a subserosal leiomyoma during pregnancy. She reported pain during her second trimester because of the leiomyoma, which disappeared with conservative treatment, and she eventually delivered at full-term. After 2 years, she opted for surgical removal of the leiomyoma. Through preoperative transvaginal ultrasonography, we suggested the tumor to be ovarian in origin because it was located far from the uterus.Laparoscopy revealed the tumor to be separated from the uterus with a 720° torsion on the vesicouterine pouch.A postoperative histopathological examination diagnosed the tumor as a parasitic leiomyoma. There have only been 24 reports of spontaneous parasitic leiomyoma, and this is the first case with associated torsion in Japan. We believe that we have experienced an extremely rare case of leiomyoma.