Disseminated Endometriosis and Leiomyomatosis Following Power Morcellation

Hariton E1*#, Bortoletto P1#, Walsh BW1, Devente JE2 and Anchan RM1

1Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, USA

2Department of Obstetrics and Gynecology, East Carolina University, USA

#Co First Authors

*Corresponding Author:
Hariton E
Department of Obstetrics
Gynecology and Reproductive Biology
Harvard Medical School, USA
Tel: (617) 732-4285
E-mail: [email protected]

Received date: August 06, 2017; Accepted date: August 09, 2017; Published date: August 12, 2017

Citation: Hariton E, Bortoletto P, Anchan RM, Devente JE, Walsh BW (2017) Disseminated Endometriosis and Leiomyomatosis Following Power Morcellation. J Reproductive Endocrinol Infert Vol. 2:23. doi: 10.21767/2476-2008.100023

Copyright: © 2017 Hariton E, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

 
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Introduction

A 45-year-old, gravida two, para two, presented to the emergency department with acute right sided pelvic pain. A CT scan demonstrated an 11 cm left adnexal solid and cystic pelvic mass, concerning for ovarian torsion. Her past surgical history was notable for a laparoscopic supracervical hysterectomy four years ago for benign indications with uncontained power morcellation.

On exploratory laparoscopy, “chocolate fluid” was noted throughout the pelvis, concerning for recent rupture of an ovarian endometrioma. There were also approximately seven smooth, round, pink lesions present in the pelvis, which appeared to be parasitic leiomyoma leiomyomata, adherent to multiple structures (Figure 1). Histopathologic examination confirmed the presence of a hemorrhagic luteinized cyst and benign leiomyomas.

reproductive-endocrinology-Intraoperative-image

Figure 1: Intraoperative image of parasitic fibroid (yellow arrow) during emergent diagnostic laparoscopy.

Surgeons considering a minimally invasive surgical approach without en bloc tissue removal should be aware of the potential complications associated with iatrogenic dissemination of benign viable endometrial and/or myometrial tissue associated with uncontained tissue morcellation [1-3].

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