Parasitic myomas and adenomyomas after myomectomy
Background. Recently, the vast majority of patients with uterine myoma seek to preserve the organ, regardless of age. Since the introduction of laparoscopic morcellation, there have been reports on the occurrence of parasitic smooth muscle tumors frequently of uncertain malignant potential. They are two types: iatrogenic parasitic myoma and iatrogenic adenomyoma that is more common.Buyanova S.N., Logutova L.S., Shchukinа N.A., Voloshchuk I.N., Babunashvili E.L., Barto R.A., Yudinа N.V., Gukasyan S.A.
Case report. The paper describes a clinical case of parasitic myomas and adenomyomas 8 years after laparoscopic myomectomy and morcellation for cell leiomyoma of large sizes, which were performed in 2011. Two years after surgery, a spontaneous pregnancy occurred, which ended successfully with abdominal delivery of a full-term baby in 2014. Pelvic organ ultrasound in 2019 revealed multiple uterine myoma and myomatous nodules of atypical location. Physicians performed laparotomy and removed multiple myomatous nodules in the uterus and large parasitic myomas and adenomyomas of the peritoneum and pelvic organs.
Conclusion. This case demonstrates the typical growth pattern of parasitic myoma several years after morcellation with its characteristic histological features and typical clinical manifestations.
Keywords
iatrogenic myoma
parasitic myoma
myomectomy
laparoscopy
morcelloma
References
- Semm K., Mettler L. Technical progress in pelvic surgery via operative laparoscopy. Am. J. Obstet. Gynecol. 1980; 138(2): 121-7. https://dx.doi.org/10.1016/0002-9378(80)90021-6.
- Semm K. Morcellement and suturing using pelviscopy – not a problem any more. Geburtshilfe Frauenheilkd. 1991; 51(10): 843-6. https://dx.doi.org/10.1055/s-2008-1026221.
- Steiner R.A., Wight E., Tadir Y., Haller U. Electrical cutting device for laparoscopic removal of tissue from the abdominal cavity. Obstet. Gynecol. 1993; 81: 471-4.
- Mallick R., Odejinmi F. Pushing the boundaries of laparoscopic myomectomy: A comparative analysis of peri- operative outcomes in 323 women undergoing laparoscopic myomectomy in a tertiary referral centre. Gynecol. Surg. 2017; 14(1): 22. https://dx.doi.org/ 10.1186/s10397-017-1025-1.
- Dubuisson J.B., Chapron C. Difficulties and complications of laparoscopic myomectomy. J. Gynecol. Surg. 1996; 12(3): 159-65. https://dx.doi.org/10.1089/gyn.1996.12.159.
- Devi Y.S., Swapna Y.K., Naidu T.K., Vaddiraju G.B. Myomectomy for uterine preservation and fertility. Int. J. Reprod. Contracept. Obstet. Gynecol. 2019; 8(7): 2668-77. https://dx.doi.org/10.18203/2320-1770.ijrcog20193023.
- Harris J.A., Swenson C.W., Uppal S., Kamdar N., Mahnert N., As-Sanie S. Practice patterns and postoperative complications before and after US food and drug administration safety communication on power morcellation. Am. J. Obstet. Gynecol. 2016; 214: 98. e1-98. e13. https://dx.doi.org/10.1016/j.ajog.2015.08.047.
- Odejinmi F., Aref-Adib M., Liou N., Sideris M., Mallick R. Rethinking the issue of power morcellation of uterine fibroids: is morcellation the real problem or is this another symptom of disparity in healthcare provision? In vivo. Int. J. Exp. Clin. Pathophysiol. Drug Res. 2019; 33(5): 1393-401. https://dx.doi.org/10.21873/invivo.11616.
- Rivard C., Salhadar A., Kenton K. New challenges in detecting, grading, and staging endometrial cancer after uterine morcellation. J. Minim. Invasive Gynecol. 2012; 19(3): 313-6.
- Taylan E., Sahin C., Zeybek B., Akdemir A. Contained morcellation: review of current methods and future directions. Front. Surg. Obstet. Gynecol. 2017; 4: 15. https://dx.doi. org/10.3389/fsurg.2017.00015.
- Тугушев М.Т., Климанов А.Ю., Игнатьев А.В. Морцелломы брюшной полости: клинический случай. Российский вестник акушера-гинеколога. 2017; 17(2): 55-8. https://dx.doi.org/10.17116/rosakush201717255-58. [Tugushev M.T., Klimanov A.Ju., Ignat'ev A.V. Abdominal morcellomas: a clinical case. Rossiiskii vestnik akushera-ginekologa/Russian Bulletin of obstetrician-gynecologist. 2017; 2: 55-58. (in Russian)]. https://dx.doi.org/10.17116/rosakush201717255-58.
- Cucinella G., Granese R., Calagna G., Somigliana E., Perino A. Parasitic myomas after laparoscopic surgery: an emerging complication in the use of morcellator? Description of four cases. Fertil. Steril. 2011; 96(2): e90-6. https://dx.doi.org/10.1016/j.fertnstert.2011.05.095.
- Ehdaivand S., Simon R.A., Sung C.J., Steinhoff M.M., Lawrence W.D., Quddus M.R. Incidental gynecologic neoplasms in morcellated uterine specimens: a case series with follow-up. Hum. Pathol. 2014; 45(11): 2311-7. https://dx.doi.org/10.1016/j.humpath.2014.07.018.
- Larraín D., Rabischong B., Khoo C.K., Botchorishvili R., Canis M., Mage G. «Iatrogenic» parasitic myomas: unusual late complication of laparoscopic morcellation procedures. J. Minim. Invasive Gynecol. 2010; 17(6): 719-24. https://dx.doi.org/10.1016/j.jmig.2010.05.013.
- Могильная Г.М., Куценко И.И., Симовоник А.Н. Переходная зона матки и аденомиоз. Журнал анатомии и гистопатологии. 2018; 7(1): 108-17. [Mogil'naja G.M., Kutsenko I.I., Simovonik A.N. The transitional zone of the uterus and adenomyosis. Zhurnal anatomii i gistopatologii/Journal of anatomy and histopathology. 2018;7(1):108-17. (in Russian)]. https://dx.doi.org/10.18499/2225-7357-2018-7-1-108-117.
- Donnez O., Van Langendonckt A., Defrère S., Colette S., Van Kerk O., Dehoux J.P., Squifflet J. Induction of endometriotic nodules in an experimental baboon model mimicking human deep nodular lesions. Fertil. Steril. 2013; 99(3): 783-9. https://dx.doi.org/10.1016/j.fertnstert.2012.10.032.
- Davey A.K., Maher P.J. Surgical adhesions: a timely update, a great challenge for the future. J. Minim. Invasive Gynecol. 2007; 14: 15-22. https://dx.doi.org/10.1016/j.jmig.2006.07.013.
- Drosch M., Bullerdiek J., Zollner T.M., Prinz F., Koch M., Schmidt N. A novel mouse model that closely mimics human uterine meiomyomas. Fertil. Steril. 2013; 99(3): 927-35. e6. https:/dx./doi.org/10.1016/j.fertnstert.2012.11.032.
- Huang B.S., Yang M.H., Wang P.H., Li H.Y., Chou T.Y., Chen Y.J. Oestrogen-induced angiogenesis and implantation contribute to the development of parasitic myomas after laparoscopic morcellation. Reprod. Biol. Endocrinol. 2016; 14: 64. https://dx.doi.org/10.1186/s12958-016-0200-y.
- Савельев C.B., Буянова C.H., Бабунашвили Е.Л., Мгелиашвили М.В. Определение роли коллагена IV типа в патогенезе миомы матки. Российский вестник акушера-гинеколога. 2005; 5(4): 7-10. [Savel'ev S.V., Buyanova S.N., Babunashvili E.L., Mgeliashvili M.V. Determination of the role of type IV collagen in the pathogenesis of uterine fibroids. Rossiiskii vestnik akushera-ginekologa/ Russian Bulletin of obstetrician-gynecologist. 2005; 4: 7-10. (in Russian).
- Хардиков А.В., Лунева И.С., Иванова О.Ю., Петров С.В., Охотников А.И., Щекин В.А. Паразитарные образования брюшной полости. Клинический случай имплантации ткани селезенки в малом тазе. Трудный пациент. 2018; 16(11): 61-3. [Hardikov A.V., Luneva I.S., Ivanova O.Ju., Petrov S.V., Ohotnikov A.I., Schekin V.A. Parasitic formations of the abdominal cavity. A clinical case of spleen tissue implantation in the pelvis. Trudnyj patsient/Difficult patient. 2018;11(16):61-3. (in Russian)]. https://dx.doi.org/10.24411/2074-1995-2018-10034.
- Van der Meulen J.F., Pijnenborg J.M., Boomsma C.M., Verberg M.F., Geomin P.M., Bongers M.Y. Parasitic myoma after laparoscopic morcellation: a systematic review of the literature. BJOG. 2016; 123: 69-75. https://dx.doi.org/10.1111/1471-0528.13541.
- Sesti F., Di Pietro C., Capece A., Piccione E. Multiple ectopic leiomyomas of the abdominal rectus muscles after gasless laparoscopic uterine myomectomy. Arch. Gynecol. Obstet. 2012; 285(3): 883-5. https://dx.doi.org/10.1007/s00404-011-2125-1.
- Raine-Bennett T., Tucker L.Y., Zaritsky E., Littell R.D., Palen T., Neugebauer R. et al. Occult uterine sarcoma and leiomyosarcoma: incidence of and survival associated with morcellation. Obstet. Gynecol. 2016; 127(1): 29-39. https://dx.doi.org/10.1097/AOG.0000000000001187.
- Flake G.P., Andersen J., Dixon D. Etiology and pathogenesis of uterine leiomyomas: a review. Environ. Health Perspect. 2003; 111(8): 1037-54. https://dx.doi.org/10.1289/ehp.5787.
- Darii N., Emil А., Doroftei В., Ciobica А., Maftei R., Anton S.C., Mostafa T. Iatrogenic parasitic myoma and iatrogenic adenomyoma after laparoscopic morcellation: A mini-review. J. Adv. Res. 2019; 20: 1-8. https://dx.doi.org/10.1016/j.jare.2019.04.004.
- Kurman R.G., Cargangiu M.L., Herrington C.S., Young R.WHO classification of tumours of female reproductive organs. 4th ed. vol. 6. Lyon: IARC Publ.;2014.
- Доброхотова Ю.Э., Хашукоева А.З., Хлынова С.А., Маркова Э.А. Паразитическая миома: всегда ли возможна профилактика? Акушерство и гинекология. 2019; 12: 18-21. [Dobrohotova Ju.E., Hashukoeva A.Z., Hlynova S.A., Markova E.A. Parasitic fibroids: is prevention always possible? Akusherstvo i ginekologija/Obstetrics and gynecology . 2019; 12:18-21. (in Russian)]. https://dx.doi.org/10.18565/aig.2019.12.18-21
- Кондриков Н.И., Баринова И.В. Патология матки. Руководство для врачей. 2-е изд. М.: Практическая медицина; 2019. З62с. [Kondrikov N.I., Barinova I.V. Pathology of the uterus. Doctor’s guide, 2nd ed. Moscow: Praсtical mediсine. 2019. 362 с. (in Russian)].
Received 29.04.2020
Accepted 07.05.2020
About the Authors
Svetlana N. Buyanova, MD, professor, head of the gynecological department of the Moscow Regional Research Institute of Obstetrics and Gynecology, Russia, Moscow.Tel.: +7(495)625-71-64. E-mail: buyanova-sn@mail.ru. ORCID: 0000-0002-1358-6640. 101000, Russia, Moscow, Pokrovka str., 22A.
Lidia S. Logutova, MD, professor, deputy chairman of the dissertation council, leading researcher of the Department for Coordination of Research and Publishing Activities of the Moscow Regional Research Institute of Obstetrics and Gynecology, Russia, Moscow.
E-mail: lidialogutova@mail.ru. ORCID: 0000-0001-8806-3273. 101000, Russia, Moscow, Pokrovka str., 22A.
Natalya A. Schukina, MD, professor, chief researcher of the gynecological department of the Moscow Regional Research Institute of Obstetrics and Gynecology, Russia, Moscow. Tel.: +7(903)594-19-28. E-mail: fluimucil@yandex.ru. ORCID: 0000-0003-2274-4070. 101000, Russia, Moscow, Pokrovka str., 22A.
Irina N. Voloshchuk, MD, professor, senior researcher, Moscow Regional Research Institute of Obstetrics and Gynecology, Russia, Moscow.
Tel.: +7(903)561-01-07. E-mail: ivoloshchuk@yandex.ru. ORCID: 0000-0002-7059-5105. 101000, Russia, Moscow, Pokrovka str., 22A.
Evgenia L. Babunashvili, candidate of medical sciences, senior researcher of the gynecological department of the Moscow Regional Research Institute of Obstetrics and Gynecology, Russia, Moscow. Tel.: +7(915)239-46-34. E-mail: babounashvili@mail.ru. ORCID: 0000-0002-3580-7221. 101000, Russia, Moscow, Pokrovka str., 22A.
Ruslan A. Barto, Ph.D., junior researcher, Moscow Regional Research Institute of Obstetrics and Gynecology, Russia, Moscow.
Tel.: +7(916)176-50-51. E-mail: md_barto@mail.ru. ORCID: 0000-0002-9859-0867. 101000, Russia, Moscow, Pokrovka str., 22A.
Natalya V. Yudina, candidate of medical sciences, researcher of the gynecological department of the Moscow Regional Research Institute
of Obstetrics and Gynecology, Russia, Moscow. Tel.: +7(916)315-52-77. E-mail: tatoscha@inbox.ru. ORCID: 0000-0002-7305-6959.
101000, Russia, Moscow, Pokrovka str., 22A.
Svetlana A. Gukasyan, candidate of medical sciences, researcher, Gynecological Department, Moscow Regional Research Institute of Obstetrics and Gynecology,
Russia, Moscow. Tel.: +7(985)567-99-33. E-mail: guka.85@mail.ru. ORCID: 0000-0002-4352-7676. 101000, Russia, Moscow, Pokrovka str., 22A.
For citation: Buyanova S.N., Logutova L.S., Shchukina N.A. Voloshchuk I.N., Babunashvili E.L., Barto R.A., Yudina N.V., Gukasyan S.A. Parasitic myomas and adenomyomas after myomectomy.Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2020; 9: 241-247 (in Russian).
https://dx.doi.org/10.18565/aig.2020.9.241-247
Similar Articles
