Parasitic Fibroid: Complication of Post-Laparoscopic Morcellation

This is a short commentary on one of the unusual complication of laparoscopic surgeries, which is difficult to diagnose, thus creating new challenges for a treating surgeon.

Uterine fibroid is a common gynaecological condition. But, one of its variants, called as parasitic fibroids, is a rare one and is difficult to diagnose because of their varied presentations. But, with the increase in laparoscopic surgeries, especially where morcellator is used, cases of parasitic fibroid are increasing.

A forty-two-year-old female presented with abdominal pain, not related to any gastrointestinal or urinary complaints. Patient had history of laparascopic myomectomy followed by morcellation in the past. Ultrasonography was suggestive of mass in right iliac region adjacent to ascending colon with whorl like appearance. Tumour markers were sent, diagnostic laparoscopy was performed which was suggestive of parasitic fibroid, arising from previous surgical port.

Complications of parasitic fibroid can occur when morcelletor is used in laparoscopic surgeries, because of the growth of tissue which have spread in pelvic cavity. To prevent this complication, endobag morcellation should be used.

History of morcellation, should be asked to females, presenting with varied abdominal complaints, and history of laparoscopic surgery, possibility of parasitic fibroid should be considered in these patients.