Diffuse Uterine Leiomyomatosis With Ovarian and Parametrial Involvement

Evaluation of different treatment modalities for diffuse uterine leiomyomatosis: A case series report and review of the literature

“…Clinical manifestations, including menorrhagia, anemia, and infertility, are similar to those of typical uterine leiomyomas, making a definitive preoperative diagnosis difficult. Unusual presentations have included associated ovarian and parametrial involvement, 4 and in another case, uterine rupture during pregnancy and associated benign metastasis of leiomyoma to bone 5 …”

“…Unusual presentations have included associated ovarian and parametrial involvement, 4 and in another case, uterine rupture during pregnancy and associated benign metastasis of leiomyoma to bone. 5 MRI, because of its multiplanar imaging capabilities and excellent soft-tissue contrast, is the optimal imaging modality for diagnosis of DUL, and plays an important role in the pre-treatment mapping, including the evaluation of the number, size, and location of leiomyoma nodules within the layers of the uterus.…”

Diffuse Leiomyomatosis of the Uterus: A Diagnostic Enigma

“…DUL can be distinguished from multiple leiomyomas by the uniform symmetrical involvement of the entire myometrium by smooth muscle nodules with indistinct borders, whereas multiple leiomyomas have asymmetrical uterine involvement with sharp circumscribed masses [ 7 ]. Disseminated peritoneal leiomyomatosis is a benign entity where the presence of uterine leiomyomas is associated with multiple mature smooth muscle nodules affecting the mesentery, visceral, and parietal fascia of the peritoneum [ 8 ]. Uterine lymphangiomatosis is characterized by the invasion of pulmonary vascular spaces [ 8 ].…”

“…Disseminated peritoneal leiomyomatosis is a benign entity where the presence of uterine leiomyomas is associated with multiple mature smooth muscle nodules affecting the mesentery, visceral, and parietal fascia of the peritoneum [ 8 ]. Uterine lymphangiomatosis is characterized by the invasion of pulmonary vascular spaces [ 8 ]. Intravascular leiomyomatosis has a creamy to yellow color, with worm-like intravascular extensions of smooth muscle tumor having multinodular irregular or indistinct margins and the presence of some or all of the neoplastic smooth muscle within the vascular channels on histopathology [ 7 ].…”

“…Thomas et al reported DUL with uterine rupture and benign metastatic lesions of the bone in a 35-year-old nulliparous woman with fetal demise [ 14 ]. Robles-Frias et al reported DUL with ovarian and parametrial involvement [ 8 ]. Agarwal et al reported a case of diffuse leiomyomatosis of the uterus diagnosed during pregnancy with successful vaginal delivery [ 15 ].…”