Parasitic abdominal leiomyomas

Abstract

Introduction: Parasitic leiomyomas (defined as extrauterine seeding of leiomyoma) is still a rare disorder; the literature is limited to case reports. Extrauterine leiomyomas present a greater diagnostic challenge. Aim: Retrospective chart review of all patients found parasitic leiomyomas. Materials and Methods: Three patients with parasitic leiomyomas, with the mean age 44.6 ± 3.4 years (range from 38 to 49) were selected in the study. Two patients had a history of abdominal subtotal hysterectomy for uterine fibroids. Physical examination, abdominal and transvaginal US and CT scan were used for diagnosis. Results: Clinical manifestations of parasitic leiomyomas included: chronic abdominal pain and palpable mass (n=2) and in one case - incidentally parasitic leiomyomas. During the surgery in all cases the mass (size from 1 to 9 cm) was separated from the uterus and adhered to the peritoneum (n=2) and small bowel mesentery (n=l). Multiple parasitic myomas were detected in two cases. Mass removal (n=2) and total abdominal hysterectomy + mass removal (n=l) were performed without complications. The histopathological findings of the resected three tumors revealed leiomyomas. Conclusions: Even though the parasitic leiomyoma is uncommon, it should be included in the differential diagnosis of abdominal mass especially in patients with a history of uterine fibroids surgery. Generally two types of parasitic leiomyomas are described: spontaneous and “iatrogenic”. Surgery is still a method of choice in the treatment strategy of parasitic leiomyomas.