EJMCR EJMCR EJMCR EJMCR EJMCR EJMCR 66 EJMCR EJMCR EJMCR EJMCR EJMCR EJMCR Laparoscopic management of ovarian parasitic myoma: a case report Ceren Gölba�ı 1 , Hakan Gölba�ı 2 , Burak Bayraktar 2* , Alper Biler 2* European Journal of Medical Case Reports Volume 5(2):66–68 © EJMCR. https://www.ejmcr.com/ Reprints and permissions: https://www.discoverpublish.com/ https://doi.org/10.24911/ejmcr/ 173-1606054161 ABSTRACT Background: Ovarian leiomyoma is very rare and consttutes 0.5%-1% of ovarian benign masses. Although most adnexal masses are benign, primary purpose of the assessment is to eliminate any malignancies. The most important issue in the evaluaton of ovarian masses is to diferentate between malignant and benign masses. Laparoscopy is an important diagnostc and minimally invasive method for these purposes. Case Presentaton: In this paper, we present a case report on laparoscopic evaluaton of a patent who was diagnosed with right ovarian spontaneous parasitc myoma and who did not have a history of uterine surgery. Conclusion: Uterine ovarian myoma is extremely rare and can be confused with malignant ovarian masses. Laparoscopy opton should be considered as the primary approach in the management of masses with suspicious locaton and appearance and in the diferentaton of benign and malignant. Keywords: Ovary, leiomyoma, adnexal mass, laparoscopy. Received: 22 November 2020 Accepted: 04 February 2021 Type of Artcle: CASE REPORT Specialty: Gynaecology and Obstetrics Correspondence to: Burak Bayraktar *Department of Obstetrics and Gynecology, University of Health Sciences Tepecik Training and Research Hospital Izmir, Turkey. Email: drburakbayraktar@gmail.com Full list of author informaton is available at the end of the artcle. Background Uterine leiomyoma is the most common benign tumor of the female pelvis and uterus [1]. The prevalence of uter- ine leiomyoma is approximately 25% of reproductive-age women [1]. Post mortem autopsy studies show a preva- lence of 50% [1]. Symptomatic patients usually require surgical treatment and uterine leiomyoma is the most common cause of hysterectomy [2]. In some cases, uterine stem fibroids may bind to neigh- boring organisms, peritoneum or omentum, losing primary focusing blood, and gaining a secondary circu- lation source. These fibroids are called parasitic fibroids. Sometimes the treatment of parasitic myomas may prove very difficult due to reasons like vascular, intestinal, and mesenteric invasion [3]. In this paper, we aimed to pres- ent a case report related to the laparoscopic approach we performed on a patient diagnosed with right ovarian spon- taneous parasitic myoma and who had no prior uterine surgery history. Case Presentation A 30-year-old female patient with gravida 3, para 1 (normal spontaneous vaginal delivery), abortion 2 was admitted to our outpatient clinic with inguinal pain for 3 months. In her gynecological examination, there was right adnexal sensitivity and distension; however, uterus and both ovaries were observed as normal in her transvaginal ultrasonography. Serum tumor markers CA-125 (14.4 U/ ml) and HE4 (8.1 pmol/l) were within the normal refer- ence range and β-human chorionic gonadotropin was negative. A lower abdominal wall magnetic resonance imaging (MRI) examination was performed due to the observation of a suspected area with regular boundaries at the anterior adjacency of the uterus. On MRI exami- nation, both ovaries were normal and after intravenous contrast agent administration, there was a homogeneous, contrast-enhancing mass of 66*49*37 mm. Laparoscopy was planned. In the laparoscopic observa- tion of the patient, the upper abdominal organs, uterus, and left ovary were in normal appearance. However, right ligamentum ovarii proprium appeared longer than normal (Figure 1). In addition, an approximately 6*6 cm mass with a solid, rigid, and vascular structure, similar to ovarian tissue, attached to the right ovary with a peduncle was observed (Figure 2). The mass was separated from the right ovary with LigaSure™. The released mass was then extracted with colpotomy using an endobag (Figures 3 and 4). Mass was delivered for frozen section and its pathology results were assessed as leiomyoma. The oper- ation was completed after colpotomy repair. The patient was discharged in a healthy condition on postoperative second day. The final pathology result of the extracted mass was reported to be consistent with leiomyoma. OPEN ACCESS