Disseminated Endometriosis and Leiomyomatosis Following Power Morcellation

Hariton E; Bortoletto P; Walsh BW; Devente JE; Anchan RM

Disseminated Endometriosis and Leiomyomatosis Following Power Morcellation

Hariton E, Bortoletto P, Walsh BW, Devente JE and Anchan RM

Published Date: 2017-08-12

Hariton E^1*#, Bortoletto P^1#, 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: ranchan@bwh.harvard.edu

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].

References

Cohen, A, Tulandi, T (2017) Long-Term sequelae of unconfined morcellation during laparoscopic gynecological surgery. Maturitas 97: 1-5.
Meulen JFVD, Pijnenborg JM, Boomsma CM, Verberg MF, Geomini PM, et al. (2016) Parasitic myoma after laparoscopic morcellation: a systematic review of the literature. BJOG 123: 69–75.
Heller DS, Cracchiolo B (2014) Peritoneal nodules after laparoscopic surgery with uterine morcellation: review of a rare complication. J Minim Invasive Gynecol 21:384-8.