Spontaneous Parasitic myoma with the omental vessel: A Case report and literature review

Spontaneous Parasitic myoma with the omental vessel: A Case report and literature review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report  Spontaneous Parasitic myoma with the omental vessel: A Case report and literature review Amala Sunder, bessy Varghese, noora bahzad, basma darwish This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-701368/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Aim: The study is the Case Report of spontaneous parasitic myoma with omental vessel, and the management at Bahrain Defense Force Hospital. Case Report : A 35years old female was diagnosed, almost 20 cm, sub serous myoma with the pedicle of 2cm from the fundus of the uterus. There was a feeding vessel from the omentum. She underwent myomectomy after the resection of pedicle and omental vessel .Post-operative period was uneventful. Conclusion : Parasitic myoma is the type of subserous uterine myoma. Generally surgical management is required for the relief of symptoms and to avoid encroachment of nearby abdominal or pelvic structures which in turn leads to further complications. Obstetrics & Gynecology Parasitic myoma omental vessel subserous feeding vessel Figures Figure 1 Figure 2 Figure 3 Introduction Parasitic myomas are the rare type of subserous uterine myomas 1,2 . whenever the subserous myomas getting attachment to the surrounding structures ,they derive the feeding vessel from them and detach from the uterine blood supply and the uterine pedicle often dissipate 3,4 . Parasitic fibroids frequently attached to omentum 3 .The other structures of attachment includes urethra ,bladder, Gastrointestional tract ,intraperitoneal and retroperotoneal myomas 5,6 . Mostly etiology is not well understood 2,7 .One of the possibility is post laparoscopic removal of uterine myomas 1,8,9 .Commonly they may not be symptomatic .Mostly diagnosis is incidental. However symptoms are in relation with the size, location, numbers and the attached structure 8 .The common symptoms include abdominal distension ,abdominal pain, pelvic pain and pressure symptoms 2,10 . Diagnosis could be assisted by imaging such as ultrasonogram ,Computed tomography (CT scan)and Magnetic Resonance Imaging (MRI) 3,8 .Management is generally surgical resection of feeding blood vessel and removal of parasitic myoma 10 . Case Report We report an infrequent case of spontaneous Parasitic Fibroid in a young unmarried Female. 35 years old, Unmarried Female with the Body Mass Index (BMI) of 23.14, who Presented to the Gynecology outpatient clinic, at Bahrain Defense Force Hospital, with the complaints of abdominal distension and pressure symptoms since two months according to her knowledge. Also she gave the history of pulsations felt at the level of umbilical region. Her menstrual cycle was regular and for the past three months less menstrual flow with duration of one day. She had no medical illness, not gone through any surgical procedures either laparoscopically or via laparotomy She was not known to have any relevant family history. Examination of Abdomen appeared as palpable mass occupying almost the entire abdomen and 3 cm above the umbilicus, also up to the Right upper quadrant. Ultrasonogram of abdomen revealed multi lobulated subserous Fibroids each measuring nearly 8 to 10cm and all together approximately 20cm.Magnetic Resonance Imaging ( MRI) pelvis reported enlarged uterus riddled with very large myomas measuring as a whole mass of almost 20x12x10cm which are avidly enhancing mostly sub serosal. Junctional zone is poorly defined due to the presence of extensive myomas. The endometrial stripe is not thickened. No pelvic lymphadenopathy. Patient was counselled for myomectomy. Upon taking informed consent after explaining possible complications such as bleeding, blood transfusion and injury to bladder /bowel /urinary tracts, she was proceeded to surgery. Abdomen was opened through the vertical midline incision in view of the huge size of Myoma. Intraoperatively identified large lobulated Myoma, attached to the fundus of the uterus with 2 cm pedicle. Also noticed vessel supply arising from the omentum to the fibroid mass. Bilateral tube and ovary grossly normal. Uterus grossly normal. The Pedicle identified, which was attached to the fundus of the uterus was clamped cut and ligated. Vascular supply to the myoma was clamped, cut and double ligation done. Myomectomy was performed and the myoma was extracted and sent for histopathological examination. Hemostasis was secured. In view of huge size Bladder integrity was checked with methylene blue instillation into bladder, and was intact. Abdomen was closed in layers with complete hemostasis. Procedure was uneventful with the Estimated blood loss approximately 500-600ml. Post-operative period was uneventful. Laboratory Findings: HB 10.6, WBC 7.96, HCT 0.33, PLT 287.BL G A Positive She was discharged on 2 nd post-operative day without any undue effects. Histopathology report reveled: Macroscopic Examination: An irregular firm pale white tissue measuring 20x17x8cm and weighing 1502g; received with attached cord-like tissue of vessels measuring 31cm long. Cut surface is pinkish in colour. (1-6=fibroid, 7=cord like tissue) Microscopic: Uterine leiomyoma of average cellularity. No significant mitosis or nuclear atypia seen. Discussion Kelly and Cullen described parasitic leiomyomas as early as 1909 11 .Their presentation is varied. These unique fibroids were classified by Nezhat and Kho into three categories. The first category spontaneously develops from pedunculated fibroids which detach from the uterus and grow by gaining blood supply from adjacent organs. The second type develops due to reduction in blood flow to the uterus and the third category develops following uterine surgeries 12 . Our case is a spontaneous fibroid in an unmarried lady which is of the second type. The third type of fibroid is suggested to be a complication of morcellator usage in laparascopic surgeries, which occurs due to tissue growth spread in the pelvic cavity concluded Ladke AB and colleagues 13 . As a solution they suggested the usage of endobag morcellation Genetic and hormonal factors may be responsible for parasitic fibroids where a history of morcellation is absent suggested AlTalib A and group 14 .A case report by Alnagar A et al revealed a different presentation of the parasitic fibroid where it was attached to the jejunum and the patient presented with small intestinal obstruction 7 .This brings out the complexity in presentation of these unusual leiomyomas. A similar case to ours was reported by Mushtaq R et al where a parasitic fibroid along with tortuous omental vessels were identified 15 . Our patient’s main concern was the abdominal distension and pressure symptoms. A literature searches on parasitic fibroids by Lete I et al gathered information on 274 patients. They found that the mean age was 40 years. 56% had no uterine surgery and 39% had a history of morcellation. The clinical symptom frequently encountered was abdominal pain which accounted for 49% 16 . Our patient was 35 years old and also did not have any kind of surgery. Ghamande SA and colleagues reported a case with high Ca -125 associated with parasitic leiomyoma 17 .Interestingly, Osegi N and group also published a case of a parasitic fibroid in a post-menopausal woman who had no history of any previous surgery 4 . Varun N and colleagues also presented a case of a parasitic fibroid in pregnancy 18 .A case report by Salih AM and group in 2017 concluded that these unique myomas presenting with vague symptoms are diagnosed by ultrasound and resection of the myoma is the management 1 .We used ultrasound and MRI along with clinical assessment for the diagnosis and myomectomy along with the double ligation of the omental vessel as the management. Conclusion Parasitic leiomyomas have a diverse presentation and causes dilemma when the condition is not kept in mind when dealing with a mass per abdomen. Hence this condition should be considered as a differential diagnosis for early management. Declarations Conflicts of Interest: None. Sponsorship: None. Written consent: has been obtained from the patient. Ethical Approval: The study was approved by the Ethical Committee and Research Centre in Bahrain Defense Force Hospital. References 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. Sofoudis Chrisostomos, Trouvas Dimitrios, Zioris Konstantinos.Torsion of intestinal parasitic myoma after laparoscopic morcellation: a case report, Journal of Surgical Case Reports , Volume 2020, Issue 3, March 2020. Ahmed S. Elagwany, Helmy A. Rady, Tamer M. Abdeldayem.A case of parasitic leiomyoma with serpentine omental blood vessels: An unusual variant of uterine leiomyoma.Journal of Taibah University Medical Sciences,Volume 9, Issue 4,( 338-340) 2014. Osegi N, Oku EY, Uwaezuoke CS, Alawode KT, Afolabi SA. Huge primary parasitic leiomyoma in a postmenopausal lady: A rare presentation. Case reports in obstetrics and gynecology. 2019 Apr 1;2019. Putran, J., Khaled, K. Parasitic leiomyomas: two case reports and review of literature. Gynecol Surg 7, 383–384 (2010). Kho KA, Nezhat C. Parasitic myomas. Obstet Gynecol. 2009 Sep;114(3):611-615. Alnagar A, Essmat A, Eltaweel N, Abdelbaqy TN, Ghazy RM, Bessa SS, Karam M, Shawky A. Can Parasitic Fibroid Present by Intestinal Obstruction? Case Report. SN Comprehensive Clinical Medicine. 2021 Feb;3(2):751-3. Oindi, F.M., Mutiso, S.K. & Obura, T. Port site parasitic leiomyoma after laparoscopic myomectomy: a case report and review of the literature. J Med Case Reports 12, 339 (2018). Grover A., Bhalla S. Parasitic leiomyoma: a rare complication following laparoscopic myomectomy with review of literature. Curr. Med. Res. Pract. 2015; 5 (6):278–281. Khan A, Shawl A, Leung PS. Parasitic leiomyoma of the greater omentum presenting as small bowel obstruction. J Surg Case Rep . 2018;2018(7) Kelly HA, Cullen TS. Myomata of the uterus. Saunders; 1909. Nezhat C, Kho K. Iatrogenic myomas: new class of myomas?. Journal of Minimally Invasive Gynecology. 2010 Sep 1;17(5):544-50. Ladke AB, Palaskar PA, Bhivsane VR. Parasitic Fibroid: Complication of Post-Laparoscopic Morcellation. The Journal of Obstetrics and Gynecology of India. 2020 Mar 29:1-3. .Al-Talib A, Tulandi T. Pathophysiology and possible iatrogenic cause of leiomyomatosis peritonealis disseminata. Gynecologic and obstetric investigation. 2010;69(4):239-44. Mushtaq R, Parveen K, Ambreen S. Conjoint presentation of large parasitic leiomyoma and serpentine omental blood vessels: a distinctive case. Journal of the Society of Obstetrics and Gynaecologists of Pakistan. 2017 Sep 6;7(2):106-9. Lete I, Gonzalez J, Ugarte L, Barbadillo N, Lapuente O, Álvarez-Sala J. Parasitic leiomyomas: a systematic review. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2016 Aug 1;203:250-9. Ghamande SA, Eleonu B, Hamid AM. High levels of CA-125 in a case of a parasitic leiomyoma presenting as an abdominal mass. Gynecologic oncology. 1996 May 1;61(2):297-8. Varun N, Elahi AA, Nigam A, Gupta N. Parasitic fibroid during Pregnancy: A Diagnostic Dilemma (Rare Case Report). Indian Journal of Obstetrics and Gynecology Research. 2017 Nov 15;4(4):458-9. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-701368","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":38370184,"identity":"9ca40ca7-ad8d-489f-8da3-7cf5128bef79","order_by":0,"name":"Amala 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\u0026nbsp;to the surrounding structures \u0026nbsp;,they derive the feeding vessel from them and detach from the uterine blood supply and the uterine pedicle often dissipate\u003csup\u003e3,4\u003c/sup\u003e. Parasitic fibroids \u0026nbsp;frequently attached to omentum\u003csup\u003e3\u003c/sup\u003e.The other structures of attachment includes urethra ,bladder, Gastrointestional tract ,intraperitoneal and retroperotoneal myomas\u003csup\u003e5,6\u003c/sup\u003e. Mostly etiology is not well understood\u003csup\u003e2,7\u003c/sup\u003e .One of the possibility is post laparoscopic removal of uterine myomas\u0026nbsp;\u003csup\u003e1,8,9\u003c/sup\u003e.Commonly they may not be symptomatic .Mostly diagnosis is incidental. However symptoms are in relation with the size, location, numbers \u0026nbsp;and the attached structure\u003csup\u003e8\u003c/sup\u003e .The common symptoms \u0026nbsp;include abdominal distension ,abdominal pain, pelvic pain and pressure symptoms\u003csup\u003e2,10\u003c/sup\u003e. Diagnosis could be assisted \u0026nbsp;by imaging such as ultrasonogram ,Computed tomography\u0026nbsp; (CT scan)and Magnetic Resonance Imaging (MRI)\u003csup\u003e\u0026nbsp;3,8\u003c/sup\u003e.Management is generally surgical resection of feeding blood vessel and \u0026nbsp;removal of parasitic myoma\u003csup\u003e10\u003c/sup\u003e\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e"},{"header":"Case Report","content":"\u003cp\u003eWe report an infrequent \u0026nbsp; case of spontaneous Parasitic Fibroid in a young unmarried Female.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e35 years old, Unmarried Female with the Body Mass Index (BMI) of 23.14, who Presented to the Gynecology outpatient clinic, at Bahrain Defense Force Hospital, with the complaints of abdominal distension and pressure symptoms since two months according to her knowledge. Also she gave the history of pulsations felt at the level of umbilical region. Her menstrual cycle was\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eregular and for the past three months less menstrual flow with duration of one day. She had no medical illness, not gone through any surgical procedures either laparoscopically or via laparotomy She was not known to have any relevant family history.\u003c/p\u003e\n\u003cp\u003eExamination of Abdomen appeared as palpable mass occupying almost the entire abdomen and 3 cm above the umbilicus, also up to the Right upper quadrant. Ultrasonogram of abdomen revealed multi lobulated subserous Fibroids each measuring nearly 8 to 10cm and all together approximately 20cm.Magnetic Resonance Imaging (\u0026nbsp;MRI) pelvis reported\u003cstrong\u003e\u0026nbsp;\u0026nbsp;\u003c/strong\u003eenlarged uterus \u0026nbsp;riddled with very large myomas \u0026nbsp;measuring \u0026nbsp;as a whole mass of \u0026nbsp;almost 20x12x10cm which are avidly enhancing mostly sub serosal. Junctional zone is poorly defined due to the presence of extensive myomas. The endometrial stripe is not thickened. No pelvic lymphadenopathy.\u003c/p\u003e\n\u003cp\u003ePatient was counselled for myomectomy. Upon taking informed consent after explaining possible complications such as bleeding, blood transfusion and injury to bladder /bowel /urinary tracts, she was proceeded to surgery. Abdomen was opened through the \u0026nbsp; vertical midline incision in view of the huge size of Myoma. Intraoperatively identified large lobulated \u0026nbsp; Myoma, attached to the fundus of the uterus with 2 cm pedicle. Also noticed vessel supply arising from the omentum to the fibroid mass. Bilateral tube and ovary grossly normal. Uterus grossly normal. The Pedicle identified, which was attached to the fundus of the uterus was clamped cut and ligated. Vascular supply to the myoma was \u0026nbsp;clamped, cut and double ligation done.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMyomectomy was performed and the myoma was extracted and sent for histopathological examination. Hemostasis was secured. In view of huge size Bladder integrity was checked with methylene blue instillation into bladder, and was intact. Abdomen was closed in layers with complete hemostasis. Procedure was uneventful with the Estimated blood loss approximately 500-600ml. Post-operative period was uneventful.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eLaboratory Findings: HB 10.6, WBC 7.96, HCT 0.33, PLT 287.BL G A Positive\u003c/p\u003e\n\u003cp\u003eShe was discharged on 2\u003csup\u003end\u003c/sup\u003e post-operative day without any undue effects.\u003c/p\u003e\n\u003cp\u003eHistopathology report reveled:\u003c/p\u003e\n\u003cp\u003eMacroscopic Examination: An irregular firm pale white tissue measuring 20x17x8cm and weighing 1502g; received with attached cord-like tissue of vessels measuring 31cm long. Cut surface is pinkish in colour. (1-6=fibroid, 7=cord like tissue)\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Microscopic: Uterine leiomyoma of average cellularity. No significant mitosis or nuclear atypia seen.\u0026nbsp;\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eKelly and Cullen described parasitic leiomyomas as early as 1909\u003csup\u003e11\u003c/sup\u003e.Their presentation is varied. These unique fibroids were classified by Nezhat and Kho into three categories. The first category spontaneously develops from pedunculated fibroids which detach from the uterus and grow by gaining blood supply from adjacent organs. The second type develops due to reduction in blood flow to the uterus and the third category develops following uterine surgeries\u003csup\u003e12\u003c/sup\u003e. Our case is a spontaneous fibroid in an unmarried lady which is of the second type. The third type of fibroid is suggested to be a complication of morcellator usage in laparascopic surgeries, which occurs due to tissue growth spread in the pelvic cavity concluded Ladke AB and colleagues\u003csup\u003e13\u003c/sup\u003e. As a solution they suggested the usage of endobag morcellation Genetic and hormonal factors may be responsible for parasitic fibroids where a history of morcellation is absent suggested AlTalib A and group\u003csup\u003e14\u003c/sup\u003e.A case report by Alnagar A et al revealed a different presentation of the parasitic fibroid where it was attached to the jejunum and the patient presented with small intestinal obstruction\u003csup\u003e7\u003c/sup\u003e.This brings out the complexity in presentation of these unusual leiomyomas.\u003c/p\u003e\n\u003cp\u003eA similar case to ours was reported by Mushtaq R et al where a parasitic fibroid along with tortuous omental vessels were identified\u003csup\u003e15\u003c/sup\u003e. Our patient\u0026rsquo;s main concern was the abdominal distension and pressure symptoms. A literature searches on parasitic fibroids by Lete I et al \u0026nbsp; gathered information on 274 patients. They found that the mean age was 40 years. 56% had no uterine surgery and 39% had a history of morcellation. The clinical symptom frequently encountered was abdominal pain which accounted for 49%\u003csup\u003e16\u003c/sup\u003e. Our patient was 35 years old and also did not have any kind of surgery. Ghamande SA and colleagues reported a case with high Ca -125 associated with parasitic leiomyoma\u003csup\u003e17\u003c/sup\u003e.Interestingly, Osegi N and group also published a case of a parasitic fibroid in a post-menopausal woman who had no history of any previous surgery\u003csup\u003e4\u003c/sup\u003e. Varun N and colleagues also presented a case of a parasitic fibroid in pregnancy\u003csup\u003e18\u003c/sup\u003e.A case report by Salih AM and group in 2017 concluded that these unique myomas presenting with vague symptoms are diagnosed by ultrasound and resection of the myoma is the management\u003csup\u003e1\u003c/sup\u003e.We used ultrasound and MRI along with clinical assessment for the diagnosis and myomectomy along with the double ligation of the omental vessel as the management.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eParasitic leiomyomas have a diverse presentation and causes dilemma when the condition is not kept in mind when dealing with a mass per abdomen. Hence this condition should be considered as a differential diagnosis for early management.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflicts of Interest:\u003c/strong\u003e None.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eSponsorship:\u003c/strong\u003e None.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWritten consent:\u003c/strong\u003e has been obtained from the patient.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Approval:\u003c/strong\u003e The study was approved by the Ethical Committee and Research Centre in Bahrain Defense Force Hospital.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eSalih AM, Kakamad FH, A H D, J Habibullah I, M Rauf G, Najar KA. Parasitic leiomyoma: A case report with literature review. \u003cem\u003eInt J Surg Case Rep\u003c/em\u003e. 2017;41:33-35.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eSofoudis Chrisostomos, Trouvas Dimitrios, Zioris Konstantinos.Torsion of intestinal parasitic myoma after laparoscopic morcellation: a case report, \u003cem\u003eJournal of Surgical Case Reports\u003c/em\u003e, Volume 2020, Issue 3, March 2020.\u003c/li\u003e\n \u003cli\u003eAhmed S. Elagwany, Helmy A. Rady, Tamer M. Abdeldayem.A case of parasitic leiomyoma with serpentine omental blood vessels: An unusual variant of uterine leiomyoma.Journal of Taibah University Medical Sciences,Volume 9, Issue 4,( 338-340) 2014.\u003c/li\u003e\n \u003cli\u003eOsegi N, Oku EY, Uwaezuoke CS, Alawode KT, Afolabi SA. Huge primary parasitic leiomyoma in a postmenopausal lady: A rare presentation. Case reports in obstetrics and gynecology. 2019 Apr 1;2019.\u003c/li\u003e\n \u003cli\u003ePutran, J., Khaled, K. Parasitic leiomyomas: two case reports and review of literature. \u003cem\u003eGynecol Surg\u003c/em\u003e \u003cstrong\u003e7,\u0026nbsp;\u003c/strong\u003e383\u0026ndash;384 (2010).\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eKho KA, Nezhat C. Parasitic myomas. Obstet Gynecol. 2009 Sep;114(3):611-615.\u003c/li\u003e\n \u003cli\u003e\u0026nbsp;Alnagar A, Essmat A, Eltaweel N, Abdelbaqy TN, Ghazy RM, Bessa SS, Karam M, Shawky A. Can Parasitic Fibroid Present by Intestinal Obstruction? Case Report. SN Comprehensive Clinical Medicine. 2021 Feb;3(2):751-3.\u003c/li\u003e\n \u003cli\u003eOindi, F.M., Mutiso, S.K. \u0026amp; Obura, T. Port site parasitic leiomyoma after laparoscopic myomectomy: a case report and review of the literature. \u003cem\u003eJ Med Case Reports\u003c/em\u003e \u003cstrong\u003e12,\u0026nbsp;\u003c/strong\u003e339 (2018).\u003c/li\u003e\n \u003cli\u003eGrover A., Bhalla S. Parasitic leiomyoma: a rare complication following laparoscopic myomectomy with review of literature. \u003cem\u003eCurr. Med. Res. Pract.\u0026nbsp;\u003c/em\u003e2015;\u003cstrong\u003e5\u003c/strong\u003e(6):278\u0026ndash;281.\u003c/li\u003e\n \u003cli\u003eKhan A, Shawl A, Leung PS. Parasitic leiomyoma of the greater omentum presenting as small bowel obstruction. \u003cem\u003eJ Surg Case Rep\u003c/em\u003e. 2018;2018(7)\u003c/li\u003e\n \u003cli\u003eKelly HA, Cullen TS. Myomata of the uterus. Saunders; 1909.\u003c/li\u003e\n \u003cli\u003eNezhat C, Kho K. Iatrogenic myomas: new class of myomas?. Journal of Minimally Invasive Gynecology. 2010 Sep 1;17(5):544-50.\u003c/li\u003e\n \u003cli\u003e\u0026nbsp;Ladke AB, Palaskar PA, Bhivsane VR. Parasitic Fibroid: Complication of Post-Laparoscopic Morcellation. The Journal of Obstetrics and Gynecology of India. 2020 Mar 29:1-3.\u003c/li\u003e\n \u003cli\u003e.Al-Talib A, Tulandi T. Pathophysiology and possible iatrogenic cause of leiomyomatosis peritonealis disseminata. Gynecologic and obstetric investigation. 2010;69(4):239-44.\u003c/li\u003e\n \u003cli\u003e\u0026nbsp;Mushtaq R, Parveen K, Ambreen S. Conjoint presentation of large parasitic leiomyoma and serpentine omental blood vessels: a distinctive case. Journal of the Society of Obstetrics and Gynaecologists of Pakistan. 2017 Sep 6;7(2):106-9.\u003c/li\u003e\n \u003cli\u003eLete I, Gonzalez J, Ugarte L, Barbadillo N, Lapuente O, \u0026Aacute;lvarez-Sala J. Parasitic leiomyomas: a systematic \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; review. European Journal of Obstetrics \u0026amp; Gynecology and Reproductive Biology. 2016 Aug 1;203:250-9.\u003c/li\u003e\n \u003cli\u003eGhamande SA, Eleonu B, Hamid AM. High levels of CA-125 in a case of a parasitic leiomyoma presenting as an abdominal mass. Gynecologic oncology. 1996 May 1;61(2):297-8.\u003c/li\u003e\n \u003cli\u003eVarun N, Elahi AA, Nigam A, Gupta N. Parasitic fibroid during Pregnancy: A Diagnostic Dilemma (Rare Case \u0026nbsp; Report). Indian Journal of Obstetrics and Gynecology Research. 2017 Nov 15;4(4):458-9.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"bahrain","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Parasitic myoma, omental vessel, subserous, feeding vessel","lastPublishedDoi":"10.21203/rs.3.rs-701368/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-701368/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eAim:\u003c/strong\u003e The study is the Case Report of spontaneous parasitic myoma with omental vessel, and the management at Bahrain Defense Force Hospital. \u003c/p\u003e\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eCase Report\u003c/strong\u003e: A 35years old female was diagnosed, almost 20 cm, sub serous myoma with the pedicle of 2cm from the fundus of the uterus. There was a feeding vessel from the omentum. She underwent myomectomy after the resection of \u0026nbsp;pedicle and omental vessel .Post-operative period was uneventful.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: Parasitic myoma is the type of subserous uterine myoma. Generally surgical management is required for the relief of symptoms and to avoid encroachment of nearby abdominal or pelvic structures which in turn leads to further complications.\u003c/p\u003e\u003cp\u003e\u003cbr\u003e\u003c/p\u003e","manuscriptTitle":"Spontaneous Parasitic myoma with the omental vessel: A Case report and literature review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2021-07-12 15:16:50","doi":"10.21203/rs.3.rs-701368/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6f3ede43-e6bf-4245-97cb-94be27bba9e5","owner":[],"postedDate":"July 12th, 2021","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":5595755,"name":"Obstetrics \u0026 Gynecology"}],"tags":[],"updatedAt":"2021-07-12T15:16:50+00:00","versionOfRecord":[],"versionCreatedAt":"2021-07-12 15:16:50","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-701368","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-701368","identity":"rs-701368","version":["v1"]},"buildId":"cBFmMYwuxLRRLfASyISRj","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}