Leiomyomatosis Peritonealis Disseminata with Features of Carcinomatosis on Laparoscopy A case report
Journal Title: Sultan Qaboos University Medical Journal - Year 2009, Vol 9, Issue 3
Abstract
Leiomyomatosis peritonealis disseminata (LPD), also known as diffuse peritoneal leiomyomatosis, is a rare disease characterised by subperitoneal proliferation of benign nodules mainly composed of benign smooth muscle cells, macroscopically mimicking peritoneal carcinomatosis. We report a 43 year-old woman who presented with menorrhagia, pelvic pressure and pain. Ultrasound of the pelvis showed uterine fbroids and an ovarian cyst. She was scheduled to have a laparoscopic hysterectomy and left salpingo-oophorectomy for symptomatic relief. A picture of carcinomatosis was seen on laparoscopy so multiple biopsies were taken and the patient was referred to the gynaecological oncology team. Defnitive surgery was performed and fnal pathology was consistent with LPD with no evidence of malignancy. No hormone replacement therapy was offered after surgery. Macroscopically, LPD has features of malignancy; it usually pursues a benign course. To review current management of LPD and the risk of malignant transformation, we conducted a search in Medline, EMBASE, and the Cochrane Database of systematic reviews using the keywords: leiomyomatosis peritonealis disseminata, management and malignant transformation. LPD is a diagnostic challenge. Although rare, malignant transformation can occur since hormones play an important role in the pathogenesis of LPD, following surgery, patients should be followed carefully if they are on hormone replacement as these tumours could re-grow and cause symptoms or transform to malignancy
Authors and Affiliations
Ayman Al-Talib| Department of Obstetrics and Gynecology, McGill University, Quebec, Canada, Abdul R Al-Farsi| Department of Obstetrics and Gynecology, McGill University, Quebec, Canada, Gerald Stanimir| Department of Obstetrics and Gynecology, McGill University, Quebec, Canada
Keywords
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