Iatrogenic Parasitic Leiomyomas: A Late and Uncommon Complication After Laparoscopic Morcellation

Parasitic leiomyoma (PL) is an extremely rare variant of uterine leiomyomas that occurs outside of the uterus and can often present like intra-abdominal tumors. The aim of this study is to report a case of PL and compare it with current literature. We present a rare case of a 45-year-old female who presented with bloating and spasmodic abdominal cramps for a two-month duration. She had a previous laparoscopic myomectomy six years ago. Transvaginal ultrasound (TVUS) showed solid vascular masses in the pelvis, the largest being 6 cm. Computed tomography (CT) of the thorax, abdomen, and pelvis (CTTAP) revealed further peritoneal masses in the left paracolic gutter suggesting peritoneal distant metastasis. Laparoscopy was completed, and biopsy and histopathological examination confirmed the diagnosis of parasitic leiomyoma. The patient opted for a bilateral salpingo-oophorectomy (BSO) creating iatrogenic menopause. One-year follow-up CT showed a reduction in the size of fibroids. PL can present with vague symptoms, typically nonspecific abdominal pain and cramping. It can often be confused with intra-abdominal tumors. It should be suspected in patients with previous uterine procedures. Histopathological examination is crucial for diagnostic and surgical management.