case_images: PMC7502794_01
case_images: (a) Horizontal view of magnetic resonance imaging (MRI) T2 weighted image demonstrates a 50-mm intramural fibroid (L) and a 60-mm left ovarian endometrioma (E) presumed adhesion to the uterus (U) before primary operation. (b) Microscopic examination of resected specimens at primary surgery shows typical leiomyoma without any specific features (Hematoxylin-eosin stain, 20x). (c) Horizontal view of MRI T2 weighted image 7 years after primary surgery illustrates a 30-mm parasitic leiomyoma (PL, arrowhead) in the left abdominal wall (Hematoxylin-eosin stain, 20x). (d) Microscopic examination of PL in the abdominal wall shows a degenerated leiomyoma with low cell density and prominent hyalinization.
case_images: 10.1177_2050313X20959223-fig1.jpg
case_images: PMC7502794_01_10.1177_2050313X20959223-fig1.jpg
case_images: fig1-2050313X20959223
case_images: A vaginal ultrasound and MRI at our department demonstrated a 50-mm fibroid in the anterior uterine wall, 72- and 39-mm fibroids in the posterior uterine wall, and a 60-mm left ovarian endometrioma with adhesion to the uterine body (Figure 1(a)). Medicine (r-ASRM) classification). Microscopic examination of the resected specimens showed leiomyoma (with arrangement of spindle cells in intersecting fascicles) with infrequent mitosis and no necrosis (Figure 1(b)) and an endometriotic cyst with no specific findings. However, MRI 7 years after the primary surgery demonstrated an increase in PL to 30 mm in diameter (Figure 1(c)); furthermore, the lesions showing intramural recurrence equally increased, showing a maximum diameter of 96 mm. Microscopic examination of the resected specimens of the intra-abdominal PL showed spindle cells arranged in intersecting fascicles accompanied by low cell density and prominent hyalinization (Figure 1(d)).