The Teaching Point

One option for hysterectomy due to symptomatic fibroids includes laparoscopic use of power morcellation. If all fragments are not removed, they may parasitize to other blood supplies and present as abdominal or pelvic masses. Intraperitoneal leiomyomas should be included in the differential diagnosis of multiple abdominal and pelvic masses in patients with a history of prior morcellator-assisted hysterectomy.






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From the manuscript

Disseminated Peritoneal Leiomyomatosis Status Post Laparoscopic Hysterectomy with Morcellation

Free full text article: Disseminated Peritoneal Leiomyomatosis Status Post Laparoscopic Hysterectomy with Morcellation

Abstract
Uterine leiomyomas (fibroids) are common benign neoplasms, which develop from the muscular tissue of the uterus with an estimated incidence of 20-40% in women of reproductive age. In the early nineties, power morcellators were introduced and became commonly used during hysterectomy for symptomatic fibroids. However, if all fragments are not removed, they may parasitize to other blood supply and present as abdominal or pelvic masses. Unfortunate cases have also been reported in which uterine sarcomas seeded throughout the abdomen and pelvis secondary to morcellation. The Food and Drug Administration (FDA) estimates that 1 in 350 women undergoing hysterectomy or myomectomy for fibroids is found to have an unsuspected uterine sarcoma. As a result, the FDA issued a press release in 2014 discouraging the use of power morcellators. Recently, the FDA approved a new containment device, the PneumoLiner, for use with certain power morcellation devices. However, it is unknown if this device will help to reduce the risk of seeding fibroids and unsuspected uterine malignancies. We present a case in which a patient who underwent morcellation therapy for symptomatic fibroids presented with recurrent abdominal and pelvic leiomyomas mimicking malignancy.






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Keyword search:

1. Fibroids

2. morcellator

3. seeding

4. implants

5. pelvis

6. uterus

7. recurrent fibroids

8. morcellation

9. Computed Tomography

10. Ultrasound

11. leiomyoma


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