INTRODUCTION: Parasitic fibroids are a rare subtype of uterine leiomyomas, classified as Type 8 in the FIGO system, alongside cervical and broad ligament myomas. These account for less than 1% of all fibroids, and while they can form spontaneously, they may also arise after surgical procedures such as morcellation. Our patient’s case highlights the latter. Although uncommon, parasitic fibroids are well-documented in the literature, and surgical removal remains the standard treatment. OBJECTIVE: The objective of this video abstract is to present a rare case of parasitic fibroid following morcellation, review its pathophysiology, and highlight key considerations for diagnosis and surgical management. METHODS: This patient is a 46-year-old female with a long-standing history of fibroids. She previously underwent hysteroscopic myomectomy and robotic myomectomy and the fibroids were removed via power morcellation. She presented with progressively worsening back and right leg pain and underwent robotic-assisted excision of intra-abdominal mass as outside imaging demonstrated a tumor within her small bowel mesentery. She was ultimately diagnosed with parasitic leiomyomas. RESULTS: Parasitic fibroids are classified as Type 8 leiomyomas on the FIGO classification, which also includes cervical and broad ligament myomas. They sustain their growth by revascularizing to adjacent tissues within the abdominal or pelvic cavity. As with all pelvic pathologies, preoperative imaging should begin with transvaginal ultrasound but can and often should include abdominal and pelvic MR if there is concern for atypical fibroids or other intra-abdominal pathology. There have been several case series and reports documenting parasitic fibroids. Parasitic fibroids are typically treated with surgical removal. CONCLUSIONS: This case highlights the importance of preoperative counseling, preparation, and a thorough inspection of the abdomen during surgery in order to address unexpected findings.
Cantave et al. (Fri,) studied this question.