Parasitic adenomyoma of the sigmoid mesentery 13 years after laparoscopic myomectomy: a case report

Abstract Introduction Parasitic adenomyomas are rare benign extrauterine lesions, particularly procedures involving morcellation. Delayed presentation and atypical locations make diagnosis challenging. Case Description A 40-year-old woman with a history of caesarean section and laparoscopic myomectomy for a single fibroid presented with chronic pelvic pain and pressure 13 years after surgery. Preoperative imaging suggested multiple uterine fibroids, and laparoscopic hysterectomy was planned. Intraoperatively, a distinct 5.3-cm mass was identified within the sigmoid mesentery and completely excised. Histopathologic examination revealed a parasitic adenomyoma composed of smooth muscle, endometrial glands, and stroma. The patient’s postoperative course was uncomplicated, with resolution of symptoms. Discussion This case represents one of the longest reported latency periods for parasitic adenomyoma and describes a previously undocumented location in the bowel mesentery following laparoscopic myomectomy of a solitary fibroid. It highlights the importance of tissue containment strategies, awareness of delayed extrauterine manifestations, and long-term follow-up after minimally invasive gynaecologic surgery.