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Parasitic Fibroids
Research Articles
Parasitic Fibroids
Kho KA,
Nezhat C.
Obstet Gynecol.
2009 Sep;114(3):611-5.
OBJECTIVE: To report a large case series of
parasitic myomas and to examine their causes, associations, and risk
factors. METHODS: Retrospective chart review was performed on 12 patients
found to have parasitic myomas between August 2000 and April 2008. The
following data were systematically collected: surgery date; indications
for surgery; number, dates, and types of prior surgeries; prior use of
morcellation; and locations of parasitic myomas. Pathologic confirmation
of all specimens was obtained. RESULTS: Laparoscopic evaluation confirmed
the presence of intraperitoneal and retroperitoneal myomas distinct from
the uterus in 12 patients. Ten of the 12 patients had prior abdominal
surgery. Eight patients had prior morcellation procedures; six performed
laparoscopically, two performed by laparotomy. Three patients had multiple
parasitic myomas, all of whom had a history of laparoscopic myomectomy
with morcellation. The majority (14 of 15) of myomas were found in the
pelvis, including two retroperitoneal myomas, one of which was embedded in
the bladder. Six of 15 myomas were found along the gastrointestinal tract,
and 1 of 15 was found in the upper abdomen. CONCLUSION: Parasitic myomas
may occur spontaneously as pedunculated subserosal myomas lose their
uterine blood supply and parasitize to other organs. More parasitic myomas
may be iatrogenically created after surgery, particularly surgery using
morcellation techniques. With increasing rates of laparoscopic procedures,
surgeons should be aware of the potential for iatrogenic parasitic myoma
formation, their likely increasing frequency, and intraoperative
precautions to minimize occurrence. LEVEL OF EVIDENCE: III.
PubMed
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