Abstract:

Objective: To improve the diagnosis and treatment of parasitic leiomyoma. Methods: 22 cases of parasitic leiomyoma admitted between September 2010 and August 2021 in the Beijing Obstetrics and Gynecology Hospital of Capital Medical University were analyzed retrospectively, including their pathogenesis, clinical characteristics, diagnosis, treatment and prevention. Results: The average age of onset of the 22 patients was (42.9±6.9) years (31-54 years). 17 patients (77.3%) were considered iatrogenic parasitic leiomyoma and 5 patients (22.7%) were spontaneous parasitic leiomyoma with no surgical history. 18 patients (81.8%) had no obvious clinical symptoms, 3 patients (13.6%) had urinary frequency and 1 patient (4.5%) had a painless mass with progressive enlargement at the original laparoscopic Trocar scar in the left lower abdomen. All 22 patients underwent surgical resection of parasitic tumors. Parasitic leiomyoma nodules ranging in size from 0.5 to 10.0 cm, implanted in the mesentery, intestinal surface, pelvic peritoneum, fallopian tube mesentery, omentum, Douglas pouch, ovary, and laparoscopic Trocar port. All patients were confirmed as leiomyomas by paraffin section pathology or immunohistochemistry. All patients had no recurrence of parasitic leiomyoma at 2-132 months postoperative follow-up. Conclusions: Parasitic leiomyoma is usually found in women of childbearing age, and most of them are considered iatrogenic parasitic leiomyoma after myomectomy. This disease lacks specific clinical symptoms and imaging, and the diagnosis mainly depends on surgical exploration and postoperative pathology. Surgery is the main treatment. Measures should be taken to prevent the parasitic leiomyoma at the time of uterine leiomyoma surgery.

Key words: Uterine neoplasms, Leiomyoma, Iatrogenic disease, Postoperative period, Universal precautions