Abdominal Parasitic Fibroids after Laparoscopic Surgery Using a Power Morcellation: A Novel Insight from Vietnam and a Narrative Revew of the Literature

Abstract

Abstract Parasitic fibroid is a rare benign pathology that can be negotiated because of its rarity. The etiology remains unknown following prior intervention related to uterine fibroids. The assessment of this rare disease is usually based on clinical features and imaging modalities. In addition, appropriate management should be individualized where appropriate. Herein, we report an uncommon case at our center and raise proper recognition for all gynecologists. Particularly, in low-and middle-income countries such as Vietnam, where the health-care system is insufficient to follow-up the long-term postoperation. A 40-year-old woman (gravida 3, para 2) presented to the gynecologic examination room due the abdominal pain and increased size of abdominal circumference. The patient had undergone laparoscopy involving the power morcellator without a contained-bag system for myomectomy at our hospital 6 years prior. The imaging diagnostic tools showed multiple hypoechoic disseminated masses in the abdominal cavity. The laparotomy intervention and histopathological endpoints confirmed completely the diagnosis of parasitic fibroid. Although an extremely rare occurrence, parasitic fibroids should be informed to all patients after laparoscopic intervention for uterine fibroids. In addition, the diagnosis of parasitic fibroid should be warranted among the patients presenting with abdominal pain after a history of fibroid resection. The power morcellation in the contained bag, uterine extraction in hysterectomy, as well as relieving the surgical specimen of uterine fibroids should be gently performed to minimize fibroid tissue disruption.