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[A parasitic myoma: unexpected finding after laparoscopic hysterectomy]
Marieke F G Verberg1, Carolien M Boomsma, Johanna M A Pijnenborg
1Medisch Spectrum Twente, afd. Gynaecologie en Verloskunde, Enschede.
Unlabelled:
During laparoscopic hysterectomy the uterus can be morcellated in order to remove it from the abdominal cavity. This technique carries a risk of tissue fragments being retained in the abdomen with recurring growth in the future.
Case Description:
A 48-year-old woman with a history of hysterectomy presented with a swelling in her lower abdomen. Ultrasound investigation showed a solid tumour with a benign appearance. Differential diagnosis included an ovarian tumour or leiomyoma. Laparoscopic investigation revealed a preperitoneal tumour which was removed by laparotomy. Histologic examination showed a benign leiomyoma.
Conclusion:
A patient with a history of hysterectomy is less likely to present with a myoma, however, in this case the diagnosis was correct. Due to the increasing use of a morcellator in laparoscopic hysterectomy in recent decades, we will be confronted with the diagnosis 'parasitic myoma' more frequently. Patients will have to be informed of the risk of this complication.
