Leyomiomatosis peritonealis disseminata associated with ovarian endometriosis in a patient submitted to hysteroscopic myomectomy

Mabrouk, Mohamed; Arena, Alessandro; Raimondo, Diego; Parisotto, Matteo; Caprara, Giacomo; Seracchioli, Renato

doi:10.1016/j.fertnstert.2019.03.023

Cited by 5 publications

(6 citation statements)

References 5 publications

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“…The high ER expression in the tumor tissue of this patient confirmed that the abdominal tumor was affected by hormonal regulation. Some scholars have reported cases of DPL complicated with endometriosis or mesothelioma, 3 , 13 but this was not found in this case.…”

Section: Discussioncontrasting

confidence: 59%

“…DPL is easy to misdiagnose as metastatic cancer, gastrointestinal stromal tumor (GIST), and mesothelioma. Currently, the pathogenesis of the disease remains unknown, but iatrogenic implantation (postoperative uterine leiomyoma), 3 hormonal effects, 4 heredity, 5 and peritoneal mesenchymal stem cell metaplasia 6 have been considered. In the past 20 years, with the application of laparoscopic surgery, the iatrogenic implant theory is being considered more often, and must be considered.…”

Section: Introductionmentioning

confidence: 99%

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

Liu

Chen

et al. 2021

J Int Med Res

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Disseminated peritoneal leiomyomatosis (DPL), also known as leiomyomatosis peritonealis disseminata, is a rare disease characterized by multiple benign smooth muscle tumors proliferating along the peritoneal surfaces. The cause of the disease is unclear, and possible factors include iatrogenic and hormonal stimulation. The patient was a 41-year-old Chinese woman with a history of laparoscopic myomectomy and subsequent pregnancy. Multiple abdominal masses were identified and required surgical intervention. The patient had no tenderness or other discomfort. The clinical and imaging diagnosis was gastrointestinal stromal tumor, but DPL was confirmed by postoperative pathological examination. The patient had a good prognosis, and no recurrence was observed during follow-up. Iatrogenic and hormonal stimulation leading to DPL is very rare, and we believe that multiple factors led to DPL in this case. Clinicians should be aware of such potential patients.

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Section: Discussioncontrasting

confidence: 59%

Section: Introductionmentioning

confidence: 99%

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

Liu

Chen

et al. 2021

J Int Med Res

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“…Most patients are usually asymptomatic, 17 and 90% of patients have symptoms suggestive of a pelvic mass, such as irregular vaginal bleeding, hypermenorrhea, menostaxis, abdominal swelling, or unexplained pelvic pain 19 ; when it compresses the ureter, it can lead to urinary tract obstruction. 20 In the middle stage, it extends out of the pelvic cavity to the renal vein or inferior vena cava and can gradually lead to edema and heaviness of the lower extremities. 21 In the late stage, it reaches the right atrium or the pulmonary artery, and chest discomfort, dyspnea and syncope develop, 22 and as the condition worsens, congestive heart failure occurs, 23 even pulmonary embolism 24 and sudden death.…”

Section: Discussionmentioning

confidence: 99%

Clinical analysis of uterine intravenous leiomyomatosis: A retrospective study of 260 cases

Peng

Zhong

Zhu

et al. 2021

J of Obstet and Gynaecol

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Methods:We collected the clinical data of 260 patients admitted to the hospital from April 2003 to September 2019 with pathologically confirmed intravenous leiomyomatosis (IVL) and followed up with these patients regularly. Univariate and multivariate logistic regression analyses were carried out on the relevant recurrence factors. Results: A total of 166 patients were regularly followed up, the median follow-up time was 36 (range 2-168) months, 14 (5.4%) patients eventually relapsed, and the median recurrence time was 8.5 (range 2-42) months. The univariate analysis showed that age (p = 0.003) and surgical type (p < 0.001) were associated with recurrence, and multivariate regression analysis demonstrated that surgical type was the only factor associated with recurrence (p < 0.001, OR 20.01). Conclusions: The use of gonadotrophin releasing hormone agonist (GnRHa) cannot reduce the postsurgical recurrence rate of patients with UIVL. Compared to total hysterectomy and bilateral salpingo-oophorectomy (TH-BSO), total hysterectomy (TH) does not increase the odds of recurrence, but the chance of recurrence with tumorectomy (TE) is 20 times higher than that of TH-BSO.

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“…In addition to laparoscopic surgery, a case of LPD in a patient with a history of hysteroscopic myomectomy has also been reported ( 25 ). The pathophysiology of LPD needs further study.…”

Section: Discussionmentioning

confidence: 99%

Leiomyomatosis Peritonealis Disseminata Following Laparoscopic Surgery With Uncontained Morcellation: 13 Cases From One Institution

et al. 2021

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Objectives: To investigate the clinical characteristics, treatment and prognosis of leiomyomatosis peritonealis disseminata (LPD) following laparoscopic surgery with uncontained morcellation and to summarize clinical features of iatrogenic LPD based on published literature together with our own experience.Methods: A cohort of 13 cases with iatrogenic LPD diagnosed and treated in Peking Union Medical College Hospital from 2011 to 2020 was reported focusing on clinical characteristics, treatment and prognosis.Results: All the patients had a history of laparoscopic myomectomy with uncontained morcellation. The average age was 35.6 (range 25–47) years. The interval between initial laparoscopic surgery and first diagnosis of LPD was 6.08 years on average (range 1–12). Most of the patients had no obvious symptoms. The accuracy of pre-operative diagnosis was low. Two patients had been treated with gonadotropin-releasing hormone agonist (GnRH-a) before surgery without obvious effect. The nodules of LPD are usually located in the lower half of the peritoneal cavity. The most commonly involved site was the pouch of Douglas. The number of nodules ranged from 3 to over 10, and they ranged in size ranged from 0.3 to 22 cm. All patients underwent surgical treatment: six patients underwent laparoscopy and seven underwent laparotomy. Pathology results confirmed LPD. The immunohistochemical profile indicated LPD tends to be positive strongly for desmin, caldesmon, ER, PR and SMA. Only one patient underwent post-operative treatment with GnRH-a. All patients were followed for an average period of 49 months without recurrence.Conclusion: Iatrogenic LPD is a relatively rare condition. Patients usually exhibit no hormonal stimulation factors. Surgery is the main method of treatment, and hormone suppressive therapy is only rarely used. The nodules are usually large and less numerous, and most involve the pelvis. The prognosis of iatrogenic LPD seems good.

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Leyomiomatosis peritonealis disseminata associated with ovarian endometriosis in a patient submitted to hysteroscopic myomectomy

Cited by 5 publications

References 5 publications

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

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

Clinical analysis of uterine intravenous leiomyomatosis: A retrospective study of 260 cases

Leiomyomatosis Peritonealis Disseminata Following Laparoscopic Surgery With Uncontained Morcellation: 13 Cases From One Institution

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