Accidental intraoperative finding of parasitic fibroids in the mesentery of a middle-aged woman

Abstract

Fibroid (myoma) is the most common benign tumor of the female genital tract. The tumour may occur in the uterine corpus as intramural, submucous, subserous, cervical fibroid; or in the broad ligament as intraligamentary fibroid or outside of uterus as parasitic fibroid. Parasitic fibroid is rare as a primary or secondary tumour. It is commonly diagnosed as an incidental finding during radiologic or abdominal surgical procedures.
This was a case report of histologically confirmed multiple parasitic fibroids in a 39-year-old woman coexisting with primary uterine fibroids. The woman presented with a history of progressive abdominal swelling and associated lower abdominal pain of 8 years duration. There was an antecedent history of exploratory laparotomy with excision of uterine mass.
Abdominal ultrasonography revealed multiple uterine fibroid nodules in the submucous, intramural and subserous layers of the uterus with bilateral normal ovaries. She had abdominal myomectomy. The intraoperative findings revealed multiple uterine fibroid nodules with a total weight of 1670g. There were multiple parasitic fibroid nodules attached to the serosa
of the colon with the largest measuring 3.5 x 2cm.
We discussed the management and associated challenges of unanticipated parasitic fibroids at surgery. We highlighted the role of multi-disciplinary care and advocated for a high index of suspicion while preparing for surgical intervention in women with multiple uterine fibroids.