September 25th, 2023

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Parasitic Leiomyomas Requiring Cytoreductive Surgery with Uterine Preservation A Case Report
Authors:  Jason L. Schwarz, M.D., Katherine C. Kurnit, M.D., and Oliver S. Eng, M.D.
BACKGROUND: Parasitic leiomyomas are benign tumors that lack connection to the uterus and derive an alternative source of blood supply. Recently, an increased incidence of these masses has been reported, possibly as a seqauela of prior uterine surgery. The presentation of parasitic leiomyomas remains highly variable, including their location, associated symptoms, and timeline to recurrence.

CASE: A 34-year-old woman with a history of prior myomectomy suffered multiple recurrent parasitic leiomyomas, the largest measuring 25 cm and situated in the pre-peritoneal space of the abdominal wall. Management of her debilitating symptoms required open cytoreductive surgery with uterine preservation and complex abdominal wall reconstruction. Because of the quick interval in which the leiomyomas reached a significant size, she was postoperatively initiated on imaging surveillance.

CONCLUSION: Recurrent parasitic leiomyomas, which may arise as a complication of prior uterine surgery, can lead to clinically significant ramifications requiring extensive surgical management. Therefore, imaging surveillance to detect recurrent parasitic leiomyomas could be warranted. Ultimately, a surveillance protocol may be applicable to other leiomyoma cases to prevent the increased morbidity and limit the need for further complex surgeries that may impact reproductive capacity.
Keywords:  cytoreductive surgical procedures, gynecologic surgery, leiomyoma, local neoplasm recurrence, uterus neoplasms
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