Leiomyomatosis peritonealis disseminata in postmenopausal women: a case report with review of literature

Abstract

BackgroundLeiomyomatosis peritonealis disseminata is an exceedingly rare benign disorder characterized by multiple vascular leiomyomas growing along the submesothelial tissues of the abdominopelvic peritoneum. It is commonly described in women of reproductive age and is rarely seen in men and postmenopausal women.Case detailsA 65-year-old female patient with a history of abdominal surgery for gastrointestinal stromal tumor presented with abdominal pain, weakness, weight loss, and vomiting. An examination revealed a chronically sick looking, emaciated patient with a long midline abdominal scar, and tenderness on deep palpation all over the abdomen. Ultrasound revealed diffuse intra-abdominal masses and a big liver mass. On laparotomy, innumerable masses were found to arise from the outer walls of whole small intestine and mesentery, and there was a soft, 8×10 cm size liver mass. Histology showed highly cellular interlacing bundles of proliferating smooth muscle cells not associated with nuclear atypia or mitotic figures, and there was no necrosis seen, suggesting cellular leiomyoma.ConclusionLeiomyomatosis peritonealis disseminata is a very rare condition, especially in men and postmenopausal women. It should be considered as a differential in patients with disseminated intra-abdominal masses arising in mesentery, peritoneum, and on walls of the intestine.

A Rare Case of Disseminated Peritoneal Leiomyomatosis: A Case Report

“…Conditions such as endometriosis, gastrointestinal tumors, disseminated ovarian tumors, and lymphoma are important differential diagnosis. 1,7 Radiological imaging, including ultrasound sonography, contrast-enhanced CT, and magnetic resonance imaging (MRI), plays a significant role in the diagnosis of DPL. These imaging modalities can help visualize the peritoneal nodules, assess their distribution and size, and guide treatment decisions.…”

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“…Esto sugiere que existe mayor sensibilidad a los estrógenos en las pacientes susceptibles. 7 También está descrito que en pacientes postembolización arterial uterina, 8 histerectomía y salpingooforectomía sucedió lo mismo. En las pacientes a quienes se practica histerectomía laparoscópica con morcelación tumoral puede aumentar la potencialidad de la implantación y diseminación tumoral.…”

Recurrent leiomyomatosis peritonealis disseminate: a case report

“…This is due to its asymptomatic nature hence the possibility of being underdiagnosed. 1,2,3,4,5 LPD is commonly noted in women of reproductive age and rarely in men or postmenopausal women. Patients usually have a history of pregnancy, oral contraceptive use, myomectomy, hysterectomy, uterine leiomyoma, or ovarian tumours.…”

“…Patients usually have a history of pregnancy, oral contraceptive use, myomectomy, hysterectomy, uterine leiomyoma, or ovarian tumours. 1,2,4,5 Clinically, LPD simulates peritoneal carcinomatosis. Accurate diagnosis requires a good history, clinical evaluation and histopathologic analysis.…”