[Primary intestinal parasitic fibroid, an incidental finding during gynecological laparoscopic surgery]. / Mioma parasitario intestinal primario como hallazgo durante la cirugía laparoscópica ginecológica.

Background: Uterine fibroids are the most frequent solid pelvic benign tumors in women. Their most common location is the uterine corpus, cervix and broad ligament but they can also be found in other areas, less commonly as extragenital locations and/or in a parasitic way. Clinical case: A 40 years old patient, who consulted for menorrhagia and dysmenorrhea on long evolution. On physical examination, the enlarged uterus, inflamated, hard consistency and normal mobility was identified. The sonographic features and location suggested a fibroid nodule type II (Wamsteker classification), which deformed the endometrial cavity. It was decided to perform the surgery and during the procedure the enlarged uterus, deformed at the expense of a localized fundal formation, like a intramural fibroid. By mobilizing the intestinal loops and change the position of the patient (Trendelenburg) a solid tumor, cranially separated from the internal genitals it was observed. In reviewing the insertion site, it was visualized that remained attached to antimesial of the jejunum. Total hysterectomy was performed with monopolar and bipolar energy, and vascular sealant. The postoperative was favorable, without complication. The pathological study reported a primary leiomyoma of the small intestine, while in the uterus of multiple myomas was confirmed. Conclusión: The parasitic fibroids are those located separately from the uterus that receive vascular irrigation from another organ or abdominopelvic structure. They are a very rare pathology. The diagnosis has made as an accidental event, during an abdominal surgery or during the differential diagnosis of a abdominopelvic tumor. The therapeutical choice depends on the clinical presentation, the location of the fibroid and the reproductive desires of the patient, most commonly recomending their surgycal removal.

Leiomioma uretral durante a gravidez: relato de caso / Urethral leiomyoma during pregnancy: a case report

The authors report a case of urethral leiomyoma diagnosed during pregnancy, which was conservatively treated up to the 38th week, when the pregnancy was interrupted. Thirty days after delivery, exeresis of the lesion was performed from the upper border of the urethral meatus and sutured with interrupted delayed-absorbable suture. The patient evolved favorably and presented no lesion recurrence during three months of follow up.

[Urethral leiomyoma during pregnancy: a case report]. / Leiomioma uretral durante a gravidez: relato de caso.

The authors report a case of urethral leiomyoma diagnosed during pregnancy, which was conservatively treated up to the 38th week, when the pregnancy was interrupted. Thirty days after delivery, exeresis of the lesion was performed from the upper border of the urethral meatus and sutured with interrupted delayed-absorbable suture. The patient evolved favorably and presented no lesion recurrence during three months of follow up.

Bowel resection for iatrogenic parasitic fibroids with preoperative investigations suggestive of malignancy.

OBJECTIVE: To describe a case in which a midline laparotomy for two presumed malignant masses instead revealed parasitic fibroids. DESIGN: Case report. SETTING: Tertiary-level private hospital. PATIENT(S): Woman with 7- and 13-cm abdominopelvic masses 3 years after a total laparoscopic hysterectomy for fibroids. INTERVENTION(S): Midline laparotomy, bilateral salpingooophorectomy, infracolic omentectomy, appendicectomy, para-aortic lymph node dissection, and high rectosigmoid resection with primary anastomosis. MAIN OUTCOME MEASURE(S): Histology of masses showed adenomyoma. RESULT(S): There was no evidence of malignancy. CONCLUSION(S): Morcellation of the fibroids during a total laparoscopic hysterectomy likely left fragments that formed iatrogenic parasitic fibroids, which led to the subsequent laparotomy and bowel resection for potential malignancy.

High levels of CA-125 in a case of a parasitic leiomyoma presenting as an abdominal mass.

A 32-year-old woman presented with increasing abdominal girth and discomfort secondary to a 18-week-size mass and a CA-125 level of 1539. She underwent an exploratory laparotomy and resection of a parasitic fibroid following which the CA-125 levels decreased and normalized within a month. A review of English literature indicates that association of raised CA-125 levels with fibroids is inconsistent and very modest and such high levels have not been previously reported.