Multiple leiomyomas after laparoscopic hysterectomy: report of two cases

We report on 2 cases of multiple leiomyomas arising in the pelvis after laparoscopic hysterectomy. One patient underwent laparoscopic myomectomy at 41 years of age and subsequently had a total laparoscopic hysterectomy for myomas 4 years later. Three years post-hysterectomy, she presented with pelvic masses that were removed laparoscopically and were leiomyomas on histopathologic examination. The other patient underwent supracervical hysterectomy for myomas with removal of a parasitic myoma from underneath the dome of the diaphragm. Eight months post-hysterectomy, she came to our office with a pelvic mass with a large myoma that was removed laparoscopically. Disseminated leiomyomas may occur after hysterectomy; and though various theories have been proposed to explain this remarkable entity, none has found universal acceptance. A thorough MEDLINE search did not reveal any reports of large pelvic masses of this size after hysterectomy or their management laparoscopically, and these are probably the first reported cases.