Multimodal imaging for diagnosis and management of parasitic peritoneal myoma with myxoid degeneration after laparoscopic-assisted myomectomy with electric power morcellation

J Obstet Gynaecol Res. 2018 Jun;44(6):1163-1168. doi: 10.1111/jog.13621. Epub 2018 Mar 8.

Abstract

A 45-year-old multipara woman was referred due to the rapid enlargement of an asymptomatic pelvic mass that was detected during a regular check up. She had undergone laparoscopic-assisted myomectomy 15 years previously. At the time, the uncontained extraction of an intraligamental myoma with electric power morcellation had been performed. Multimodal imaging revealed a heterogeneous mass in the vesicouterine pouch that was found to be supplied by the left gastro-omental and superior vesical arteries. Although malignancy could not be completely denied, parasitic peritoneal myoma with myxoid degeneration was the most probable diagnosis. Single-port laparoscopic excision of the peritoneal mass was performed along with laparoscopic-assisted vaginal hysterectomy and bilateral salpingo-oophorectomy. The excised peritoneal mass was placed into a retrieval bag and extracted through the vagina. The pathological diagnosis was a parasitic peritoneal myoma with myxoid degeneration. The postoperative course was uneventful, and there was no recurrence of parasitic myoma in the 1-year follow up after surgery.

Keywords: diagnostic imaging; laparoscopic-assisted myomectomy; myxoid degeneration; parasitic myoma; power morcellation.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Humans
  • Laparoscopy / methods*
  • Middle Aged
  • Morcellation / adverse effects*
  • Multimodal Imaging
  • Myoma* / diagnosis
  • Myoma* / etiology
  • Myoma* / pathology
  • Myoma* / surgery
  • Neoplasm Seeding*
  • Peritoneal Neoplasms* / diagnosis
  • Peritoneal Neoplasms* / pathology
  • Peritoneal Neoplasms* / secondary
  • Peritoneal Neoplasms* / surgery
  • Uterine Myomectomy / adverse effects*