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寄生性肌瘤的保守治疗与超声随访:我们的经验及文献综述

Conservative Management and Ultrasound Follow-Up of Parasitic Myoma: Our Experience and Literature Review.

作者信息

Bruno Matteo, Pelaccia Erika, Di Florio Christian, Palumbo Pierpaolo, Sollima Laura, Ludovisi Manuela, Guido Maurizio

机构信息

Obstetrics and Gynaecology Unit, San Salvatore Hospital, 67100 L'Aquila, Italy.

Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy.

出版信息

Diagnostics (Basel). 2023 May 22;13(10):1818. doi: 10.3390/diagnostics13101818.

Abstract

A uterine fibroid is a benign smooth muscle neoplasm of the uterus. Parasitic fibroids (PMs) are a type of myoma that do not have any direct attachment to the uterus. PMs can arise from the implantation of tissue fragments generated during the morcellation process in previous laparoscopic myomectomies or hysterectomies. Transvaginal ultrasound (TV-US) may be helpful in the diagnosis of these benign tumors. Almost all the case reports in the literature suggest surgical management of parasitic fibroids. Conversely, we report an ultrasound-guided histological diagnosis and a non-surgical treatment of a parasitic myoma that arose twenty years after a total laparotomic hysterectomy and bilateral adnexectomy in a patient with multiple comorbidities, in order to offer a follow-up alternative to the management of this rare pathology. Our experience reveals that a non-surgical conservative approach can be considered as an alternative therapeutic option for the management of rare cases such as PMs in highly selected patients.

摘要

子宫肌瘤是子宫的一种良性平滑肌肿瘤。寄生性肌瘤(PMs)是一种与子宫没有任何直接附着的肌瘤类型。PMs可源于先前腹腔镜子宫肌瘤切除术或子宫切除术中粉碎过程产生的组织碎片植入。经阴道超声(TV-US)可能有助于这些良性肿瘤的诊断。文献中几乎所有的病例报告都建议对寄生性肌瘤进行手术治疗。相反,我们报告了一例在全腹式子宫切除术和双侧附件切除术后20年出现的寄生性肌瘤,通过超声引导下的组织学诊断和非手术治疗,该患者有多种合并症,目的是为这种罕见病理的管理提供一种随访替代方案。我们的经验表明,对于高度选择的患者中PMs等罕见病例的管理,非手术保守方法可被视为一种替代治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e49/10217399/95617ffe593b/diagnostics-13-01818-g001.jpg

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