Simultaneously occurring disseminated peritoneal leiomyomatosis and multiple extrauterine adenomyomas following hysterectomy

Abstract

Disseminated peritoneal leiomyomatosis (DPL), also known as leiomyomatosis peritonealis disseminata, is a rare condition characterized by multiple benign smooth muscle tumors proliferating along the peritoneal surfaces. In previous case reports, these tumors have been noted to involve the ovaries, round ligaments, bladder, bowel, peritoneum, and mesentery. To date, approximately 150 cases of DPL have been described in the literature. Extrauterine adenomyoma is an even rarer entity, involving benign tumors composed of smooth muscle tissue, endometrial glands, and endometrial stroma arising outside the uterus. Only 22 cases have previously been reported. We describe a woman presenting with both DPL and multiple extrauterine adenomyomas several years after undergoing laparoscopic morcellated hysterectomy.

A rare case of ovarian adenomyoma mimicking primary invasive ovarian cancer with a contralateral serous borderline ovarian tumor: A case report and review of the literature

“…[ 52 ] 52 × 27 mm, left ovary 45 Endometrial polyp Hypermenorrhea USG fibroma or thecoma Total abdominal hysterectomy and bilateral salpingo-oopherectomy 40 Belmarez et al. [ 53 ] multiple masses adherent to the rectosigmoid colon, vaginal cuff, and descending colon (from 6 mm to 14.5 cm) 50 Robotic laparoscopic hysterectomy for large uterine fibroids using the morcellation technique, without utilizing a bag Progressive abdominal bloating and indigestion USG, CT malignancy Bilateral salpingo-oophorectomy, segmental sigmoid colectomy and tumor debulking B 41 Mandal et al. [ 54 ] 90 × 80 × 80 mm, left ovary 60 Pelvic pian USG malignancy Total abdominal hysterectomy and bilateral salpingo-oopherectomy with omental biopsy M 42 Presented case 63 × 62 × 60 mm, left ovary 40 Endometriosis Pelvic pain USG, CT malignancy Bilateral salpingo-oophorectomy, omentectomy, peritoneal biopsies C …”

Extrauterine adenomyomas presenting in a 47 year old woman with a previous cesarean section

“…To date, approximately 35 cases of extrauterine adenomyomas have been published in the literature based upon the most comprehensive review article to date (Paul et al, 2018) and PubMed search of articles published in the time since the review article publication (Belmarez et al, 2019). We present a case to further add to the knowledge of this rare finding in a patient with history only significant for a cesarean section.…”

“…It is therefore important that gynecologic oncologists be aware of this rare possibility and understand the current theories of the pathophysiology behind it given the lack of current treatment recommendations when discovered. Surveillance and treatment to date have ranged from none to ovarian suppression with a GnRH agonist (similar to treatments proposed for another rare entity, disseminated peritoneal leiomyomatosis, depending on the presentation and which mechanistic theory is considered most likely, (Paul et al, 2018, Belmarez et al, 2019, Carinelli et al, 2009). There is currently no consensus by any medical group that we know of.…”

“…A theory which has not been formally published but has been commonly discussed regarding leiomyomatosis peritonealis is that of pelvic seeding during surgeries to the reproductive tract (Belmarez et al, 2019). It has been considered that during hysterectomy or myomectomy, cells can be seeded within the abdomen and pelvis which can lead to extrauterine leiomyomas, especially when morcellation without a bag occurs.…”

Two Rare Entities in One Patient: Mucinous Tubular and Spindle Cell Carcinoma of the Kidney and Peritoneal Adenomyomas

“…The pathogenesis behind extrauterine adenomyomas is not well understood, in part because of the rarity of the condition. Several reported cases consider a history of gynecological surgery as a contributing factor [8] , [9] , [10] , [11] , [12] , [13] , [14] .…”