Pei-Shen Huang1, Wen-Chun Chang2, Su-Cheng Huang3. 1. Department of Obstetrics and Gynecology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan. 2. Department of Obstetrics and Gynecology, National Taiwan University Hospital, School of Medicine, National Taiwan University, Taipei, Taiwan. 3. Department of Obstetrics and Gynecology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, Tzu Chi University, Hualien City, Taiwan. Electronic address: muse_caffeine@hotmail.com.
Abstract
OBJECTIVE: To investigate the possible causes of iatrogenic parasitic myoma and methods to prevent its occurrence. CASE REPORT: A 27-year-old nulliparous unmarried patient underwent laparoscopic myomectomy with morcellation for a submucosal myoma at the National Taiwan University Hospital (Taipei, Taiwan). Seven years later, an asymptomatic pelvic tumor was noted during a regular annual follow up. Two pelvic tumors were detected and excised by laparoscopic surgery. The masses were confirmed by histopathology to be cellular leiomyomas. CONCLUSION: In the past 7 years, the incidence of iatrogenic parasitic myomas has increased because of the increased use of minimally invasive surgery using a morcellator. Forty-one cases of iatrogenic parasitic myoma were reviewed from 23 published studies. Parasitic myoma frequently occurs in the dependent part of the abdominal cavity, which suggests seeding of myometrial tissues during morcellation. In situ morcellation and vigorous irrigation with concomitant changes in position may decrease the incidence of retained myoma tissue in the abdomen during surgery.
OBJECTIVE: To investigate the possible causes of iatrogenic parasitic myoma and methods to prevent its occurrence. CASE REPORT: A 27-year-old nulliparous unmarried patient underwent laparoscopic myomectomy with morcellation for a submucosal myoma at the National Taiwan University Hospital (Taipei, Taiwan). Seven years later, an asymptomatic pelvic tumor was noted during a regular annual follow up. Two pelvic tumors were detected and excised by laparoscopic surgery. The masses were confirmed by histopathology to be cellular leiomyomas. CONCLUSION: In the past 7 years, the incidence of iatrogenic parasitic myomas has increased because of the increased use of minimally invasive surgery using a morcellator. Forty-one cases of iatrogenic parasitic myoma were reviewed from 23 published studies. Parasitic myoma frequently occurs in the dependent part of the abdominal cavity, which suggests seeding of myometrial tissues during morcellation. In situ morcellation and vigorous irrigation with concomitant changes in position may decrease the incidence of retained myoma tissue in the abdomen during surgery.
Authors: In Ae Cho; Jong Chul Baek; Ji Kwon Park; Dae Hyun Song; Wan Ju Kim; Yoon Kyoung Lee; Ji Eun Park; Jeong Kyu Shin; Won Jun Choi; Soon Ae Lee; Jong Hak Lee; Won Young Paik Journal: Obstet Gynecol Sci Date: 2016-01-15