Parasitic peritoneal leiomyomatosis diagnosed 6 years after laparoscopic myomectomy with electric tissue morcellation: Report of a case and review of the literature

Takeda, Akihiro; Mori, Masahiko; Sakai, Kotaro; Mitsui, Takashi; Nakamura, Hiromi

doi:10.1016/j.jmig.2007.07.004

Cited by 102 publications

(76 citation statements)

References 10 publications

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“…Because the symptoms of parasitic myomas are not specific, the number of case reports with asymptomatic presentation should not be underestimated (12)(13)(14)(15)(16). In our review, 13 of 53 patients (25%) were asymptomatic.…”

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confidence: 75%

Parasitic myoma after laparoscopic surgery: a mini-review

Erenel

Temizkan

Mathyk

et al. 2015

J Turkish German Gynecol Assoc

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Parasitic myoma is a term used to describe a myoma of extrauterine nourishing. Although uterine myomas are the most common female tumors, parasitic myomas are rare pathologic structures of uncertain etiology. One theory suggests that pedunculated subserosal myomas become separated from the uterus and receive blood supply from other adjacent organs, such as the bowel, peritoneum, omentum, or mesentery (1). Peritoneal metaplasia is another theory that describes the pathogenesis of myomas in unexpected fields of abdomen. The development of multiple nodules on peritoneal surfaces is referred to as leiomyomatosis peritonealis disseminata (LPD), which was first described in 1952 by Wilson et al. (2). Different pathological mechanisms related to hormonal factors, genetic basis, pregnancy, oral contraceptive pills, and prior surgery have been described in the literature. Estrogen exposure can stimulate metaplasia and differentiation of subperitoneal mesenchymal stem cells to smooth muscle cells (3). LPD is usually considered as a premenopausal benign condition; however, malignant transformation and postmenopausal status have also been observed in exceptional cases (4, 5). A recent report showed that currently, there are approximately 200 cases of LPD (6). In the last decade, there have been increasing reports of parasitic myomas after laparoscopic surgery, which have been newly classified as iatrogenic parasitic myomas (7). These myomas are related to the small fibroid fragments left after morcellation that could have detached from the uterus and developed blood supply from adjacent organs. In this paper, we aimed to summarize and discuss the various reports of parasitic myomas after laparoscopic uterine surgery.This systematic review was conducted in accordance with the PRISMA guidelines. Literature search was performed using the PubMed database for the period of January 1997 to December 2014. We used following keywords: "laparoscopic hysterectomy," "laparoscopic myomectomy," "morcellation," "parasitic fibroids," "parasitic myomas," and "leiomyomatosis." Specifically, reports written in English language and in which patients with parasitic myoma underwent laparoscopic uterine surgery were considered eligible for our review. Articles including patients who underwent laparotomy or vaginal surgery or who were operated on account of retained myoma in the initial surgery were excluded. Reports with malignant pathology results were also excluded from our review. The flow chart for the study selection process is shown in Figure 1. From the selected articles, the number, size, receptor status, location of parasitic myomas, usage of morcellator in previous surgery, and type of previous laparoscopic uterine surgery were determined. After the initial literature search, 36 articles were identified for review. However, after screening the language, 2 reports were excluded because they were not written in English. Of the remaining 34 reports, 5 did not meet the inclusion criteria and were thus excluded (4 reports involved previous l...

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confidence: 75%

Parasitic myoma after laparoscopic surgery: a mini-review

Erenel

Temizkan

Mathyk

et al. 2015

J Turkish German Gynecol Assoc

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“…These cells get implanted at various locations and grow there to form parasitic leiomyomas [1,2]. An article published by Takeda et al has exploited this temporal relationship between the laparoscopic surgery and the development of multiple peritoneal leiomyomata [3]. In current case also laparoscopic hysterectomy was done for large uterine leiomyoma two years back when morcillation was done.…”

Section: Discussionmentioning

confidence: 96%

Benign Metastasising Leiomyoma: Is it a Real Threat After Morcillation?

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J²

2015

JCR

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Abstract:Benign metastasising leiomyoma is a rare entity in which multiple benign fibroid tumors develop along the peritoneum. Due to its temporal relationship with laparoscopic hysterectomy particularly when morcillator was used to extract the specimen, it becomes interesting to understand whether this condition occurs due to implantation of the benign tumor cells. Here we present a case where post-laparoscopic hysterectomy, multiple benign fibroids have developed along the peritoneal cavity.

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“…Electromechanical morcellation during laparoscopic hysterectomy and myomectomy can remove large specimens, but with risk of incomplete removal. A few recent case reports and small series [2][3][4] have found association of parasitic myomas with history of previous laparoscopic surgeries with morcellation, which suggests an iatrogenic mechanism for parasitic myoma. These iatrogenic myomas arise from fragments inadvertently left behind in the peritoneal cavity previous morcellation procedure [5] Parasitic fibroids are rare complication of fibroids and with the increase of electromechanical morcellation during laparoscopic myomectomy and hysterectomy the incidence is likely to increase [5].…”

Section: Discussionmentioning

confidence: 99%