Sinha Rakesh, Sundaram Meenakshi, Lakhotia Smita, Kadam Pratima, Rao Gayatri, Mahajan Chaitali
Bombay Endoscopy Academy and Centre for Minimally Invasive Surgery (Beams Hospital), Mumbai, India.
J Gynecol Endosc Surg. 2009 Jul;1(2):113-5. doi: 10.4103/0974-1216.71612.
We report an interesting case of parasitic fibroid which developed from a morcellation remnant following laparoscopic myomectomy. The patient presented with incidental finding of pelvic mass in 2005. She underwent laparoscopic myomectomy for a myoma extending from the Pouch of Douglas to both sides of broad ligament. She subsequently presented with abdominal pain 3 years later in 2008. She underwent total laparoscopic hysterectomy with removal of broad ligament fibroids. During her hysterectomy, a right lumbar mass attached to the omentum was detected, which was excised laparoscopically. Histopathology of the mass confirmed it to be consistent with leiomyoma. This mass could probably be a morcellation remnant that has grown to this size taking blood supply from the omentum. We report this case to emphasize that all tissue pieces that are morcellated should be diligently removed. Even small bits displaced into the upper abdomen can result in parasitic fibroids. Thus, it can be concluded that parasitic myomas can arise from morcellated remnants and grow depending on the blood supply.
我们报告了一例有趣的寄生性肌瘤病例,该肌瘤由腹腔镜子宫肌瘤剔除术后的碎瘤组织残留发展而来。患者于2005年偶然发现盆腔肿块。她因一个从Douglas窝延伸至阔韧带两侧的肌瘤接受了腹腔镜子宫肌瘤剔除术。2008年,也就是3年后,她出现腹痛症状。她接受了全腹腔镜子宫切除术,并切除了阔韧带肌瘤。在子宫切除术中,发现一个附着于大网膜的右侧腰部肿块,通过腹腔镜将其切除。肿块的组织病理学检查证实其与平滑肌瘤相符。这个肿块可能是一个碎瘤组织残留,它从大网膜获取血液供应并生长到了这个大小。我们报告此病例是为了强调所有被切碎的组织块都应被认真清除。即使是少量移位到上腹部的组织块也可能导致寄生性肌瘤。因此,可以得出结论,寄生性肌瘤可起源于碎瘤组织残留,并根据血液供应情况生长。