Endometriosis occurring in leiomyomatosis peritonealis disseminata

Kuo, Tseng-tong; London, Steve N.; Dinh, Tung Van

doi:10.1097/00000478-198004000-00012

Cited by 42 publications

(23 citation statements)

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“…12 Williams and Pavlick have suggested that most of the leiomyomata of the uterus are probably additional foci of LPD, rather than uterine leiomyomata, since in most instances they are subserosal in location. 2 Another frequent association is the presence of endometriosis 5,7,9 and occasionally ovarian teratoma, 6 as in the present case. Histologic examination usually reveals bundles of spindle cells with no significant nuclear pleomorphism or mitoses characteristic of a leiomyoma, as it was in this case.…”

Section: Figure 1 a Section Of The Peritoneal Nodule Showing Mature supporting

confidence: 65%

“…Several reports have demonstrated endometrial glandular inclusion within the leiomyomatous nodules in the LPD. 7,9 Endometriosis and LPD have been found in the same patient. The submesothelial mesenchymal cells are multipotential, and may differentiate into endometriosis, 9 or into smooth muscle-causing LPD, or to decidua and later into myofibroblast, which in turn may differentiate into smooth muscle.…”

Section: Figure 1 a Section Of The Peritoneal Nodule Showing Mature supporting

confidence: 55%

“…7,9 Endometriosis and LPD have been found in the same patient. The submesothelial mesenchymal cells are multipotential, and may differentiate into endometriosis, 9 or into smooth muscle-causing LPD, or to decidua and later into myofibroblast, which in turn may differentiate into smooth muscle. Although a few studies have demonstrated an imbalance in the hormone status in these patients, the results are contradictory.…”

Section: Figure 1 a Section Of The Peritoneal Nodule Showing Mature supporting

confidence: 55%

“…3,4 Most of the cases reported were in their reproductive years and were mostly associated with pregnancy. [4][5][6] Some of the non-pregnant women were under hormonal therapy, [7][8][9] or had granulosa cell tumor of the ovary. 1 A few cases were in the menopausal or perimenopausal age groups.…”

Section: Discussionmentioning

confidence: 99%

“…Ultrastructural studies clearly demonstrate a leiomyomatous differentiation. 2,9 The lesions are always well defined, and no evidence of infiltration is observed in the surrounding soft tissue. Although decidual reaction has been described in some LPD cases associated with pregnancy, 6 in this case the group of cells were separated by edematous stromal tissue but no definitive decidual reaction was noted.…”

Section: Figure 1 a Section Of The Peritoneal Nodule Showing Mature mentioning

confidence: 99%

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Leiomyomatosis Peritonealis Disseminata

Baez-Giangreco¹,

Afzal²,

Sharkawy

et al. 2000

Ann Saudi Med

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Leiomyomatosis peritonealis disseminata (LPD) is a relatively rare clinical entity which is characterized by the presence of multiple nonneoplastic nodules, mainly due to smooth muscle proliferation over the surface of the abdominopelvic peritoneal cavity. It is usually an incidental finding during procedures such as laparoscopy, cesarean section, laparotomy, and postpartum tubal ligation, and it occurs mainly in women, primarily during the reproductive period. When LPD occurs during pregnancy or during the use of birth control pills, it may regress spontaneously after delivery or discontinuation of the use of the pills. Conservative care is indicated, particularly if fertility is desired. In this study, we report a case of LPD in a pregnant Egyptian woman. To our knowledge, this is the first case reported in an Arab woman. Case ReportA 38-year-old pregnant Egyptian woman of 38 weeks' gestation, gravida 4 para 3, was admitted to the Maternity Hospital, Riyadh Medical Complex, for a cesarean section. The previous history of the patient was unremarkable, except for two previous lower segment cesarean sections for cephalopelvic disproportion, with no intraoperative or postoperative complications. The patient had used oral contraceptive pills for a period of one year three years previously, but there was no other history of use of intrauterine contraceptive device or other hormonal treatment. Physical examination on admission revealed temperature of 37°C, blood pressure of 120/80, and mild lower limb edema. Abdominal examination revealed normal pregnancy at term cephalic 4/5.Within six hours of admission, the patient underwent a cesarean section, and a baby girl was delivered weighing 4.95 kg, with an Apgar score of 9.99. Examination of the abdomen during surgery revealed multiple (about 20-25) small fleshy nodules varying in diameter from 0.1 to 0.5 cm, and scattered over the uterus, fallopian tubes, omentum, and anterior abdominal wall. No nodules were seen over the bowel surface or the liver. A left ovarian multilocular cystic mass measuring 10x6x6 cm was observed. No ascitis was present and the uterus appeared free of any intramural tumor. With a possible diagnosis of disseminated carcinomatosis, examination of a frozen section specimen from one of the nodules was made, which revealed the mass to be a benign leiomyoma. Bilateral salpingooophorectomy and biopsy of another peritoneal nodule was carried out. The postoperative recovery was uneventful and the patient was discharged on the eighth postoperative day. Follow-up ultrasound examination three months later revealed no more nodular masses in the abdominal cavity. Pathologic FindingsThe left ovary was replaced by a well-defined cystic mass measuring 10x6x6 cm. The right ovary was unremarkable. A cross-section view of the left ovarian mass showed a cystic cavity filled with thick granular yellow material with some hair structures. The two biopsies from the peritoneal nodules measured 0.7x0.5x0.5 cm in diameter each. They were smooth and glistening, firm, and pa...

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Section: Figure 1 a Section Of The Peritoneal Nodule Showing Mature supporting

confidence: 65%