A case of multiple parasitic leiomyomas as complication of incomplete myomectomy

Abstract

Uterine leiomyoma is the most common neoplastic process affecting the female gynaecological tract, with an incidence of approximately 30% of women over 35.1 It is an entity that is easy to identify, diagnose and manage when it presents in the uterus. However as an extra-uterine presentation, it can become a diagnostic dilemma. Extra-uterine leiomyomas are known as parasitic leiomyomas. They were first identified in 1909 by Kelly and Cullen, however there has been an rise in the incidence since the increasing use of laparoscopic myomectomies with power morcellators.2 It is postulated that small fragments of leiomyoma implant themselves into the pelvic organs, like parasites, if not removed in its entirety. This case study presents a patient with multiple parasitic leiomyomas in the bladder, sigmoid colon, omentum, left adnexa, right adnexa and abdominal wall following 6 myomectomies over 5 years, the second with a power morcellator. This case study attempts to increase the awareness of this rare variant of uterine leiomyoma.