Disseminated peritoneal leiomyomatosis: an unusual presentation of intra-abdominal lesion mimicking disseminated malignancy

Abstract

Leiomyoma are commonly seen as benign smooth muscle tumors of the uterus. Smooth muscle tumors with unusual growth pattern are rare and include 3 primary neoplasms: intravenous leiomyomatosis (IVL), benign metastasizing leiomyoma (BML) and disseminated peritoneal leiomyomatosis (DPL). DPL is a rare benign disease, often giving the appearance of metastatic ovarian or peritoneal carcinoma. It is a disease that predominately affects women at their reproductive age. The risk of malignant transformation is 2-5%. There are no standard treatment guidelines for the management of the DPL. The unusual presentation of the disease delays the diagnosis or is often misdiagnosed and thus over treated, which may lead to increased morbidity and mortality. Therefore careful consideration and high index of suspicion is required for the proper management of such cases.

Disseminated peritoneal leiomyomatosis: a case report and review of the literature

“…19 Of concern with DPL is a tendency for recurrence and malignant transformation, with a reported risk of malignant degeneration of 2% to 5%. 20 Chiu et al. believe that several instances of huge tumors and recurrence are an indicator of malignancy.…”

Pseudo broad ligament fibroid mimicking ovarian malignancy: a case report

“…Unusual growth patterns or unusual locations make their identification more challenging both clinically and radiologically. 3 When fibroids undergo massive cystic degeneration they may present clinical and sonologic diagnostic difficulties. In this case report a huge palpable mass and ultrasound appearance of extensive tumor with solid areas raised the suspicious of ovarian malignancy.…”

Disseminated Peritoneal Leiomyomatosis: A Case Report of an Incidental Finding During an Emergency Caesarean Section and a Review of the Literature

“…Fasih et al [10] classified leiomyomas occurring outside the uterus according to the different sites and described them as a separate disease entity referred to as leiomyomas beyond the uterus (LBU) [10]. The atypical locations of these tumours usually present a diagnostic dilemma regarding their origin and biologic nature [11]. DPL is a very rare benign entity characterised by the presence of multiple leiomyomatous nodules throughout the peritoneal cavity, often giving the appearance of metastatic ovarian or primary peritoneal carcinoma [11].…”

“…The atypical locations of these tumours usually present a diagnostic dilemma regarding their origin and biologic nature [11]. DPL is a very rare benign entity characterised by the presence of multiple leiomyomatous nodules throughout the peritoneal cavity, often giving the appearance of metastatic ovarian or primary peritoneal carcinoma [11]. The estimated prevalence of DPL is less than 1/10,00,000 with fewer than 150 cases reported in literature [11].…”