Leiomyomatosis peritonealis disseminata mimicking peritoneal carcinomatosis 13 years after laparoscopic uterine myomectomy: A case report

Huang, Shih-Feng; Wen, Chen-Yueh; Liao, Cheng-I; Lin, Jung-Chia; Tsai, Cheng-Chung

doi:10.1016/j.ijscr.2021.105745

Cited by 10 publications

(9 citation statements)

References 9 publications

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“…During the rotatory resection of uterine broids, small pieces and spray-like broid tissues and cells undetected by the naked eye remain in the peritoneum or omentum and eventually develop into LPD with a dependence on angiogenesis. Such a process may last years or even decades [10,11]. Miyaka et al [12] reported a case of LPD and con rmed the monoclonal origin of uterine leiomyomas in the rst surgery and LPD tumors in the second and third surgeries using the nonrandom X-chromosome inactivation pattern.…”

Section: Discussionmentioning

confidence: 99%

Combination therapy of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for recurrent leiomyomatosis peritonealis disseminata with endometriosis: a case report

Xiao

Zhang

et al. 2023

Preprint

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Background Leiomyomatosis peritonealis disseminata (LPD) is a non-metastatic, homologous, multicentric benign disorder characterized by small leiomyomas scattered over the peritoneum and omentum. It is a rare and benign disease with invasive potential. LPD mainly attacks women of childbearing age, but it has also been reported in postmenopausal women, men, and young children. Non-specific clinical and imaging findings of LPD lead to difficult diagnoses and treatment. Case presentation This study reports the case of a patient with recurrent LPD with endometriosis after multiple myomectomies and hysterectomy, who presented recurrent abdominal pain with progressive exacerbation. Imaging examinations showed irregular shadows in the pelvic cavity and multiple nodular changes in the peritoneum, which were considered malignant lesions. A solid mass sized 10 mm × 9 mm × 10 mm in the inferior pelvis and nodules scattered over the surface of pelvic and abdominal organs and the peritoneum were detected during the surgery. The patient was treated with cytoreductive surgery (CRS), peritonectomy, ovarian ablation, and hyperthermic intraperitoneal chemotherapy (HIPEC). The surgery was challenging, and the intraoperative bleeding reached 900 ml. However, the patient recovered well and achieved a tumor-free survival of 13 months. Conclusions It was concluded that a combination of CRS, peritonectomy, ovarian ablation, and HIPEC is an effective therapeutic strategy for recurrent LPD.

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Section: Discussionmentioning

confidence: 99%

Combination therapy of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for recurrent leiomyomatosis peritonealis disseminata with endometriosis: a case report

Xiao

Zhang

et al. 2023

Preprint

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“…Literature search was conducted using the PubMed database with the keywords: "parasitic leiomyoma", "parasitic myoma", and "omentum", identifying 12 English-language reports [2,5,[7][8][9][10][11][12][13][14][15][16] . Detailed information regarding the size, number, and torsion status of PLs in the greater omentum, as well as patient age, symptoms, previous surgical history, and the use of a morcellator during surgery, was extracted from these studies.…”

Section: Discussionmentioning

confidence: 99%

A parasitic leiomyoma of the greater omentum disguised as an abdominal tumor：a case report and literature review

Xie,

Li,

Zhu

et al. 2024

Preprint

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Parasitic leiomyoma (PL) is an exceedingly rare type of leiomyoma characterized by the distribution of multiple nodules across various organ surfaces within the pelvic and abdominal cavities, mimicking malignant tumor implants. PLs originating from the greater omentum are notably rare, with few cases reported thus far. Their nonspecific clinical presentations, such as abdominal distension, ascites, and urinary difficulties, often lead to their misidentification as abdominal malignancies. The considerable mobility of the greater omentum facilitates PL torsion, potentially causing ischemic necrosis of the tumor mass and presenting as acute abdomen, which complicates diagnosis further. Clinicians should consider the possibility of PLs of the greater omentum in patients with a history of uterine fibroids or prior fibroid surgeries. This review highlights a case of a patient who experienced sudden onset abdominal pain eight years after undergoing laparoscopic myomectomy. Intraoperative findings confirmed torsion and necrosis of a PL on the greater omentum, leading to the surgical removal being deemed the most suitable treatment method.

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“…Recently, iatrogenic tumor implantation following laparoscopic myomectomy or hysterectomy has aroused widespread attention. There has been an increasing number of reports on LPD after laparoscopic myomectomy with power morcellation [16][17][18], during which small fibroid fragments might be missed and left in the abdominal cavity. They may implant into the peritoneum, mesentery, intestines or omental tissues.…”

Section: Discussionmentioning

confidence: 99%

Large leiomyomatosis peritonealis disseminata with ascites and pleural effusion eight years after laparoscopic supracervical hysterectomy: an extremely rare case and review of literature

2024

EJGO

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Leiomyomatosis peritonealis disseminata is a rare benign disease characterized by the appearance of multiple pelvic and abdominal nodules. Its pathogenesis remains unclear and preoperative diagnosis is difficult. Here, we report a case of Leiomyomatosis peritonealis disseminata in a 48-year-old woman with post-polio paralysis and complaints of lower abdominal distending pain. Eight years ago, she underwent a laparoscopic supracervical hysterectomy with electronic power morcellator without an in-bag containment system. Medical imaging showed unilateral pleural effusion, a small amount of ascites and a large cystic-solid mass that filled the pelvis and abdomen, measuring 25 cm in size, following which she underwent bilateral adnexectomy, omentectomy, residual cervical resection and removal of all visible lesions. Histopathology confirmed the diagnosis of Leiomyomatosis peritonealis disseminata. To our best knowledge, large Leiomyomatosis peritonealis disseminata with ascites and pleural effusion has not been previously reported in literature. Our study showed that the patient was disease-free without any evidence of recurrence for over half a year after surgery, suggesting that the surgical resection of the tumors and bilateral adnexal was an effective and reasonable treatment. These observations suggest that more consideration should be given to Leiomyomatosis peritonealis disseminata after laparoscopic myomectomy or supracervical hysterectomy with power morcellation.

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Leiomyomatosis peritonealis disseminata mimicking peritoneal carcinomatosis 13 years after laparoscopic uterine myomectomy: A case report

Cited by 10 publications

References 9 publications

Combination therapy of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for recurrent leiomyomatosis peritonealis disseminata with endometriosis: a case report

Combination therapy of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for recurrent leiomyomatosis peritonealis disseminata with endometriosis: a case report

A parasitic leiomyoma of the greater omentum disguised as an abdominal tumor：a case report and literature review

Large leiomyomatosis peritonealis disseminata with ascites and pleural effusion eight years after laparoscopic supracervical hysterectomy: an extremely rare case and review of literature

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