Parasitic leiomyoma – a case report and review of the literature

Czech version

Authors: K. Hlinecká ¹; A. Richtárová ¹; Z. Lisá ¹; D. Kužel ¹; Hanáček J. ²
Authors‘ workplace: Gynekologicko-porodnická klinika 1. LF UK a VFN v Praze ¹; Ústav pro péči o matku a dítě, Praha ²
Published in: Ceska Gynekol 2021; 86(6): 400-405
Category: Case Report
doi: https://doi.org/10.48095/cccg2021400

Overview

Objective: The aim of this study is to report a case of parasitic leiomyoma in a brief literature report. Case report: A 40-year-old woman was repeatedly examined for chronic abdominal pain in 2020. Lesions presented on CT images showed suspicion of carcinomatosis or endometriosis. Her past history is a laparoscopic myomectomy and hysteroscopic transcervical resection of myoma. Conclusion: Parasitic leiomyoma or leiomyomatosis peritonealis disseminata is an extremely rare variant of uterine leiomyoma occurring outside the uterus. According to the International Federation of Gynecology and Obstetric classification, parasitic leiomyoma has been classified as type 8. Previous laparoscopic myomectomy with intraperitoneal morcellation has been implicated in its etiology. The most common symptom – if present, is abdominal pain, pressure, bloating during eating or nausea.

Keywords:

parasitic leiomyoma – intraperitoneal morcellation – leiomyomatosis

Sources

1. Salih AM, Kakamad FH, Dahat AH et al. Parasitic leiomyoma: a case report with literature review. Int J Surg Case Rep 2017; 41: 33–35. doi: 10.1016/j.ijscr.2017.10.003.

2. Sarmalkar M, Nayak A, Singh N et al. A rare case of primary parasitic leiomyoma mimicking as ovarian mass: a clinical dilemma. Int J Reprod Contracept Obstet Gynecol 2016 2016; 5 (2): 545–548. doi: 10.18203/2320-1770.ijrcog20160409.

3. Pai AH, Yen CF, Lin SL. Parasitic leiomyoma. Gynecol Minim Invasive Ther 2020; 9 (2): 108–109. doi: 10.4103/GMIT.GMIT_35_20.

4. Tan-Kim J, Hartzell KA, Reinsch CS et al. Uterine sarcomas and parasitic myomas after laparoscopic hysterectomy with power morcellation. Am J Obstet Gynecol 2015; 212 (5): 594.e1 –594.e10. doi: 10.1016/j.ajog.2014.12.002.

5. Donnez O, Squifflet J, Leconte I et al. Posthysterectomy pelvic adenomyotic masses observed in 8 cases out of a series of 1,405 laparoscopic subtotal hysterectomies. J Minim Invasive Gynecol 2007; 14 (2): 156–160. doi: 10.1016/j.jmig.2006.09.008.

6. Pereira N, Buchanan TR, Wishall KM et al. Electric morcellation-related reoperations after laparoscopic myomectomy and nonmyomectomy procedures. J Minim Invasive Gynecol 2015; 22 (2): 163–176. doi: 10.1016/j.jmig.2014.09.006.

7. Huang PS, Chang WC, Huang SC. Iatrogenic parasitic myoma: a case report and review of the literature. Taiwan J Obstet Gynecol 2014; 53 (3): 392–396. doi: 10.1016/j.tjog.2013.11.007.

8. Kotani Y, Tobiume T, Fujishima R et al. Recurrence of uterine myoma after myomectomy: open myomectomy versus laparoscopic myomectomy. J Obstet Gynaecol Res 2018; 44 (2): 298–302. doi: 10.1111/jog.13519.

9. Brody S. Parasitic fibroid. Am J Obstet Gynecol 1953; 65 (6): 1354–1356. doi: 10.1016/0002- 9378 (53) 90380-9.

10. Tulandi T, Leung A, Jan N. Nonmalignant sequelae of unconfined morcellation at laparoscopic hysterectomy or myomectomy. J Minim Invasive Gynecol 2016; 23 (3): 331–337. doi: 10.1016/j.jmig.2016.01.017.

11. Cohen A, Tulandi T. Long-term sequelae of unconfined morcellation during laparoscopic gynecological surgery. Maturitas 2017; 97: 1–5. doi: 10.1016/j.maturitas.2016.11.007.

12. Leren V, Langebrekke A, Qvigstad E. Parasitic leiomyomas after laparoscopic surgery with morcellation. Acta Obstet Gynecol Scand 2012; 91 (10): 1233–1236. doi: 10.1111/j.1600-0412.2012.01453.x.

13. Van der Meulen JF, Pijnenborg JM, Boomsma CM et al. Parasitic myoma after laparoscopic morcellation: a systematic review of the literature. BJOG 2016; 123 (1): 69–75. doi: 10.1111/1471-0528.13541.

14. Lete I, González J, Ugarte L et al. Parasitic leiomyomas: a systematic review. Eur J Obstet Gynecol Reprod Biol 2016; 203: 250–259. doi: 10.1016/j.ejogrb.2016.05.025.

15. Cucinella G, Granese R, Calagna G et al. Parasitic myomas after laparoscopic surgery: an emerging complication in the use of morcellator? Description of four cases. Fert Steril 2011; 96 (2): e90–e96. doi: 10.1016/j.fertnstert.2011.05.095.

16. Levitz J. Fibroid Surgery Puts Doctor Fighting Cancer Diagnosis in Spotlight. The Wall Street Journal, 19.12. 2013. 2013 [online]. Available from: https: //www.wsj.com/articles/fibroid-surgery-puts-doctor-fighting-cancer-diagnosis-in-spotlight-1387457121.

17. Odejinmi F, Aref-Adib M, Liou N et al. Rethinking the issue of power morcellation of uterine fibroids: is morcellation the real problem or is this another symptom of disparity in healthcare provision? In Vivo 2019; 33 (5): 1393–1401. doi: 10.21873/invivo.11616.

18. Sandberg EM, van den Haak L, Bosse T et al. Disseminated leiomyoma cells can be identified following conventional myomectomy. BJOG 2016; 123 (13): 2183–2187. doi: 10.1111/1471-0528.14265.

19. Takeda A, Tsuge S, Shibata M et al. Identification of leiomyoma cell sheets in peritoneal washings retrieved by an intraoperative red blood cell salvage device during laparoscopic-assisted myomectomy with in-bag manual tissue extraction: a pilot study. J Minim Invasive Gynecol 2018; 25 (7): 1266–1273. doi: 10.1016/j.jmig.2018.03.026.

20. Yu SP, Lee BB, Han MN et al. Irrigation after laparoscopic power morcellation and the dispersal of leiomyoma cells: a pilot study. J Minim Invasive Gynecol 2018; 25 (4): 632–637. doi: 10.1016/j.jmig.2018.01.027.

21. Barnaś E, Raś R, Skręt-Magierło J et al. Natural history of leiomyomas beyond the uterus. Medicine (Baltimore) 2019; 98 (25): e15877. doi: 10.1097/md.0000000000015877.

22. Demirkiran F, Sal V, Kaya U et al. Intravenous leiomyoma with extension to the heart: a case report and review of the literature. Case Rep Obstet Gynecol 2013; 2013: 602407. doi: 10.1155/2013/602407.

23. Förster A. Lehrbuch der pathologischen anatomie. Jena: Fridrich Mauke 1896.

24. Norris HJ, Parmley T. Mesenchymal tumors of the uterus. V. Intravenous leiomyomatosis. A clinical and pathologic study of 14 cases. Cancer 1975; 36 (6): 2164–2178. doi: 10.1002/cncr. 2820360935.

25. Lam PM, Lo KW, Yu MY et al. Intravenous leiomyomatosis: two cases with different routes of tumor extension. J Vasc Surg 2004; 39 (2): 465–469. doi: 10.1016/j.jvs.2003.08.012.

26. Castelli P, Caronno R, Piffaretti G et al. Intravenous uterine leiomyomatosis with right heart extension: successful two-stage surgical removal. Ann Vasc Surg 2006; 20 (3): 405–407. doi: 10.1007/s10016-006-9024-0.

27. Li B, Chen X, Chu YD et al. Intracardiac leiomyomatosis: a comprehensive analysis of 194 cases. Interact Cardiovasc Thorac Surg 2013; 17 (1): 132–138. doi: 10.1093/icvts/ivt117.

28. Shi T, Shkrum MJ. A case report of sudden death from intracardiac leiomyomatosis. Am J Forensic Med Pathol 2018; 39 (2): 119–122. doi: 10.1097/paf.0000000000000377.

29. Pai AH, Yen CF, Lin SL. Parasitic leiomyoma. Gynecol Minim Invasive Ther 2020; 9 (2): 108–109. doi: 10.4103/gmit.Gmit_35_20.

30. Lam PM, Lo KW, Yu MM et al. Intravenous leiomyomatosis with atypical histologic features: a case report. Int J Gynecol Cancer 2003; 13 (1): 83–87. doi: 10.1136/ijgc-00009577200301000-00015.