Torsion of a parasitic myoma that developed after abdominal myomectomy

Iatrogenic parasitic myomas are rare. The condition is defined by the presence of multiple smooth-muscle tumorous nodules in the peritoneal cavity. This may be attributable to seeding of myoma particles during uterine surgery. The clinical course is usually indolent. The disease is often asymptomatic and is usually discovered only incidentally. A 38-year-old woman who had undergone abdominal myomectomy 7 months prior presented with acute abdominal pain and a huge pelvic mass. We performed exploratory laparotomy. A parasitic mass 17 cm in diameter with a twisted omental pedicle was identified. En bloc excision of the mass and omentum was performed, followed by total abdominal hysterectomy. Histopathological examination of multiple sections revealed features compatible with an infarcted leiomyoma. Thus, we present a very rare case of an iatrogenic, rapidly growing parasitic myoma complicated by omental torsion (which caused the acute abdominal pain). We also offer a literature review.

Differential Diagnosis of Congenital Cervical Masses in Infants and Children / 소아알레르기및호흡기학회지

PURPOSE: Cervical masses are frequently occurred in children. They are most often associated with nonspecific infection. However, they may be presented as congenital abnormalities. Therefore, accurate history taking, physical examination and appropriate diagnostic procedure are absolutely required for the differential diagnosis of neck mass in children. METHODS: To elucidate the clinical characteristics of cervical mass which may help for establishing a correct diagnosis, the clinical records including pathologic findings from the biopsied specimen of twenty-eight children under seventeen years of age who were hospitalized with complain of persistently palpable neck mass were completely reviewed. RESULTS: Pathologic classification of the cervical mass was as follows : 15(53.6%) thyroglossal duct cyst, 7(25.0%) branchial cleft cyst, 5(17.9%) cystic hygroma and 1(3.6%) bronchogenic cyst. Asymptomatic mass was the most common presentation(67.8%). Twenty-six (92.8%) lesions were solitary and 2(7.1%) branchial cleft cyst were multiple. All thyroglossal duct cyst presented as a solitary mass and involved the midline of the neck. Branchial cleft cysts were located around sternocleidomastoid muscle, and multiple branchial cleft cyst located bilaterally in submandibular area. CONCLUSIONS: The accurate medical history, physical examination, and additional pathologic findings are the most important for the diagnosis of congenital neck mass in children.