Immunohistologic Detection of Estrogen and Progesterone Receptors in Disseminated Peritoneal Leiomyomatosis

Düe, W.; Pickartz, H

doi:10.1097/00004347-198903000-00006

Cited by 41 publications

(11 citation statements)

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“…Heinig et al [12] reported recurrences of LPD in a woman who used hormonal replacement therapy requiring 6 laparotomies. Others reported spontaneous regression of LPD after discontinuation of hormones such oral contraceptive pills or after a pregnancy [28,29] . …”

Section: Hormonal Theorymentioning

confidence: 99%

Pathophysiology and Possible Iatrogenic Cause of Leiomyomatosis Peritonealis Disseminata

Al-Talib

Tulandi²

2010

Gynecol Obstet Invest

134

123

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We present a case of leiomyomatosis peritonealis disseminata (LPD) after myoma morcellation and review the literature using the keywords leiomyomatosis peritonealis disseminata and disseminated peritoneal leiomyomatosis. The search was conducted in Medline, EMBASE, and Cochrane Database of systematic reviews. We encountered 132 cases of LPD in the English literature; 113 in the reproductive age group, 7 in postmenopausal women, 6 in males, and another in a horse. The possible causes could be divided into hormonal, subperitoneal mesenchymal stem cells, metaplasia, genetic, or iatrogenic after morcellation of myoma during laparoscopic surgery. Our case and 4 others reported in the literature support the contribution of the iatrogenic theory. It appears that LPD could be due to metaplasia of mesenchymal cells of the peritoneum and, in susceptible women, leaving fragments of myoma in the abdominal cavity might contribute to the development of LPD. Accordingly, one should avoid leaving fragments of the uterus or myoma tissue in the abdominal cavity after morcellation.

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Section: Hormonal Theorymentioning

confidence: 99%

Pathophysiology and Possible Iatrogenic Cause of Leiomyomatosis Peritonealis Disseminata

Al-Talib

Tulandi²

2010

Gynecol Obstet Invest

134

123

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“…Estrogens and progesterone are considered as the main factors initiating the formation of disseminated leiomyomatosis. Their receptors can be revealed by immunohistochemical methods [6]. The difficulty in DPL diagnosis is that it is not always accompanied by scattered leiomyomas and can occur after menopause [5].…”

Section: Introductionmentioning

confidence: 99%

A case of disseminated peritoneal leiomyomatosis after two laparoscopic procedures due to uterine fibroids.

Ciebiera¹,

Słabuszewska-Jóźwiak²,

Zaręba³

et al. 2017

Videosurgery and Other Miniinvasive Techniques

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Disseminated peritoneal leiomyomatosis (DPL) is a rare disorder characterized by the presence of multifocal nodules and tumors composed of proliferating smooth muscle tissue, spread throughout the peritoneum. Estrogens and progesterone are considered to be the main factors initiating the formation of disseminated leiomyomatosis. Disseminated peritoneal leiomyomatosis is often asymptomatic, and acyclic vaginal bleeding or pain in the lower abdomen is associated with leiomyomatous rebuilt uterus corpus. Disseminated peritoneal leiomyomatosis can have other ambiguous presentation. The difficulty in DPL diagnosis is that it is not always accompanied by scattered leiomyomas and can occur after menopause. Some cases of DPL are associated with surgical procedures on uterine fibroids, especially with the use of a morcellator. We present the case of a 39-year-old woman with DPL who underwent laparoscopic myomectomy and laparoscopic supracervical hysterectomy before the final diagnosis of DPL. After the complete surgical treatment performed in our center the patient is free of symptoms.

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“…There is evidence to suggest that LPD is a product of a hormonal imbalance, such as its exclusive occurrence in women, the association with pregnancy, hormone administration, granulosa cell tumor and regression after surgical castration, as well as the reduction in the size of the tumor after termination of pregnancy. Furthermore the presence of estrogen and progesterone receptors within the cells of the lesion, 13 and the experimental production of LPD in guinea pigs by the administration of estrogen alone or in combination with progesterone, 14,15 support the hormonal background of this disorder.…”

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

confidence: 80%

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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Immunohistologic Detection of Estrogen and Progesterone Receptors in Disseminated Peritoneal Leiomyomatosis

Cited by 41 publications

References 0 publications

Pathophysiology and Possible Iatrogenic Cause of Leiomyomatosis Peritonealis Disseminata

Pathophysiology and Possible Iatrogenic Cause of Leiomyomatosis Peritonealis Disseminata

A case of disseminated peritoneal leiomyomatosis after two laparoscopic procedures due to uterine fibroids.

Leiomyomatosis Peritonealis Disseminata

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