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腹腔镜子宫肌瘤切除术后出现大量寄生性肌瘤的罕见病例。

A rare case of numerous parasitic myomas after laparoscopic myomectomy.

作者信息

Fujita Kazuhisa, Tsukada Kazuhiko, Utsumi Fumi, Sugihara Kazuhiro, Urano Makoto, Shibata Kiyosumi

机构信息

Department of Obstetrics and Gynecology, Fujita Health University, Bantane Hospital, Nagoya, Japan.

Department of Diagnostic Pathology, Fujita Health University, Bantane Hospital, Nagoya, Japan.

出版信息

J Obstet Gynaecol Res. 2025 Jan;51(1):e16187. doi: 10.1111/jog.16187.

Abstract

Parasitic myoma is a relatively rare disease in which one or more leiomyomas form outside the uterus; however, the detailed causes are unknown. Few sporadic reports are available, and per our research, the maximum number of parasitic myomas reported to date was 26, and almost all cases were treated by surgical resection. We report a rare case of numerous parasitic myomas in the abdominal cavity, possibly including an intrathoracic lesion, which could not be resected completely. The patient was a 42-year-old, gravid 2, para 0, artificially aborted 2, and not yet menopausal woman. She had undergone laparoscopic myomectomy at a different hospital 6 years prior. Laparoscopically, numerous hard white masses, ranging from 1 mm to approximately 55 mm in size, were found in the abdominal cavity. The masses were particularly numerous in the omentum and mesentery but were also found on the diaphragm, abdominal peritoneum, and intestinal surface. The patient was pathologically diagnosed with multiple benign leiomyomas. On computed tomography, a similar nodule was observed in the right lower lobe of the lung. Despite using in-bag morcellation, as in this case, numerous parasitic myomas occurred, suggesting that greater caution should be exercised when explaining laparoscopic myomectomy to patients.

摘要

寄生性肌瘤是一种相对罕见的疾病,其中一个或多个平滑肌瘤在子宫外形成;然而,具体病因尚不清楚。仅有少数散发病例报道,根据我们的研究,迄今为止报道的寄生性肌瘤的最大数量为26个,几乎所有病例均通过手术切除治疗。我们报告一例罕见的腹腔内大量寄生性肌瘤病例,可能包括一个胸腔内病变,无法完全切除。患者为42岁女性,孕2产0,人工流产2次,尚未绝经。6年前她在另一家医院接受了腹腔镜子宫肌瘤切除术。腹腔镜检查发现腹腔内有大量坚硬的白色肿物,大小从1毫米到约55毫米不等。这些肿物在大网膜和肠系膜中尤为多见,但在膈肌、腹膜和肠表面也有发现。患者经病理诊断为多发性良性平滑肌瘤。在计算机断层扫描中,右肺下叶观察到一个类似的结节。尽管在此病例中使用了袋内分碎术,但仍出现了大量寄生性肌瘤,这表明在向患者解释腹腔镜子宫肌瘤切除术时应更加谨慎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cae8/11647432/031641ab286b/JOG-51-0-g001.jpg

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