title: Iatrogenic parasitic myoma: a case report and review of the literature.
abstract: OBJECTIVE
  To investigate the possible causes of iatrogenic parasitic myoma and methods to prevent its occurrence.
  
  
  METHODS
  A 27-year-old nulliparous unmarried patient underwent laparoscopic myomectomy with morcellation for a submucosal myoma at the National Taiwan University Hospital (Taipei, Taiwan). Seven years later, an asymptomatic pelvic tumor was noted during a regular annual follow up. Two pelvic tumors were detected and excised by laparoscopic surgery. The masses were confirmed by histopathology to be cellular leiomyomas.
  
  
  CONCLUSIONS
  In the past 7 years, the incidence of iatrogenic parasitic myomas has increased because of the increased use of minimally invasive surgery using a morcellator. Forty-one cases of iatrogenic parasitic myoma were reviewed from 23 published studies. Parasitic myoma frequently occurs in the dependent part of the abdominal cavity, which suggests seeding of myometrial tissues during morcellation. In situ morcellation and vigorous irrigation with concomitant changes in position may decrease the incidence of retained myoma tissue in the abdomen during surgery.
authors.affiliation: Department of Obstetrics and Gynecology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
authors.forename: Pei-Shen
authors.initials: PS
authors.lastname: Huang
authors.affiliation: Department of Obstetrics and Gynecology, National Taiwan University Hospital, School of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Wen-Chun
authors.initials: WC
authors.lastname: Chang
authors.affiliation: Department of Obstetrics and Gynecology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, Tzu Chi University, Hualien City, Taiwan. Electronic address: muse_caffeine@hotmail.com.
authors.forename: Su-Cheng
authors.initials: SC
authors.lastname: Huang
mesh_terms: D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation*; D006801:Humans; D007049:Iatrogenic Disease; D010535:Laparoscopy / Q000295:instrumentation*; D007889:Leiomyoma / Q000473:pathology* / Q000601:surgery; D018231:Leiomyomatosis / Q000175:diagnosis; D009214:Myoma / Q000601:surgery*; D009366:Neoplasm Seeding; D014594:Uterine Neoplasms / Q000556:secondary* / Q000601:surgery
keywords: disseminated peritoneal leiomyomatosis; iatrogenic parasitic myoma; laparoscopic myomectomy; morcellation in situ