Wandering Fibroid: An Unusual Complication Arising from an Unusual Location

Abstract

Wandering fibroids are exceedingly uncommon extrauterine neoplasms. They occur in unusual locations that can confound imaging and diagnosis. We present a case of a woman, with a lump in the abdomen, whose imaging revealed uterine fibroids and an apparently unrelated solid mass adherent to the anterior abdominal wall. Guided biopsy resulted in the unusual complication of an inferior epigastric artery branch injury for which embolization was done. Post embolization, the size of the mass reduced. Iatrogenic inferior epigastric artery injury is rare and can result in a large rectus sheath hematoma. Active bleeding is life threatening and warrants immediate intervention.

Keywords - parasitic fibroid - inferior epigastric artery embolization - wandering fibroids

• References

• 1 Salih AM, Kakamad FH, A H D, J Habibullah I, M Rauf G. Najar KA. Parasitic leiomyoma: A case report with literature review. Int J Surg Case Rep 2017; 41: 33-35
• 2 Sobkin PR, Bloom AI, Wilson MW. et al. Massive abdominal wall hemorrhage from injury to the inferior epigastric artery: a retrospective review. J Vasc Interv Radiol 2008; 19 (03) 327-332
• 3 Berek JS. Uterine fibroids. In: Berek JS. ed. Berek & Novak's Gynecology. 15th ed.. Philadelphia, PA: Lipincott Williams & Wilkins; 2013: 444-500
• 4 Robbins SL, Cotran RS, Kumar V. Pathologic Basis of Disease. 3rd ed.. Philadelphia, PA: W.B. Saunders; 1984: 1109
• 5 Kelly HA, Cullen TS. Myomata of the Uterus. Philadelphia, PA: WB Saunders; 1909
• 6 Kho KA, Nezhat C. Parasitic myomas. Obstet Gynecol 2009; 114 (03) 611-615
• 7 Lu B, Xu J, Pan Z. Iatrogenic parasitic leiomyoma and leiomyomatosis peritonealis disseminata following uterine morcellation. J Obstet Gynaecol Res 2016; 42 (08) 990-999
• 8 Gaspare C, Roberta G, Gloria C, Edgardo S. Parasitic myomas after laparoscopic surgery: an emerging complication in the use of morcellator?. Description of four cases. Fertil Steril 2011; 96 (02) 90-96
• 9 Zaitoon MM. Retroperitoneal parasitic leiomyoma causing unilateral ureteral obstruction. J Urol 1986; 135 (01) 130-131
• 10 Sarmalkar M, Nayak A, Singh N, Mehendale M, Dixit P. A rare case of primary parasitic leiomyoma mimicking as ovarian mass: a clinical dilemma. Int J Reprod Contracept Obstet Gynecol 2016; 5 (02) 545-548
• 11 Nappi L, Bettocchi S, Carriero C, Ceci O, Vimercati A, Resta L. Large parasitic leiomyoma of the broad ligament. J Gynecol Surg 2004; 20 (03) 97-102
• 12 Sobkin PR, Bloom AI, Wilson MW. et al. Massive abdominal wall hemorrhage from injury to the inferior epigastric artery: a retrospective review. J Vasc Interv Radiol 2008; 19 (03) 327-332
• 13 Williams PL. Gray's Anatomy. 38th ed.. Edinburgh: Churchill Livingstone; 1995: 1563
• 14 Aggarwal P, Kangjam P, Singh MR, Akoijam U. Inferior epigastric artery injury during vaginal delivery. Int J Sci Res 2015; 4 (05) 688