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Leiomyomatosis peritonealis dissemianata five years after laparoscopic uterine myomectomy: A case report

Annals of medicine and surgery, 2021-06, Vol.66, p.102377, Article 102377 [Peer Reviewed Journal]

2021 The Authors ;2021 The Authors. ;2021 The Authors 2021 ;ISSN: 2049-0801 ;EISSN: 2049-0801 ;DOI: 10.1016/j.amsu.2021.102377 ;PMID: 34026111

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  • Title:
    Leiomyomatosis peritonealis dissemianata five years after laparoscopic uterine myomectomy: A case report
  • Author: Thang, Nguyen Manh ; Thien, Dang Hong ; Huyen Anh, Nguyen Thi ; Cuong, Tran Danh
  • Subjects: Case Report ; Leiomyoma ; Leiomyomatosis peritonealis dissemianata ; Morcellation
  • Is Part Of: Annals of medicine and surgery, 2021-06, Vol.66, p.102377, Article 102377
  • Description: Leiomyomatosis peritonealis disseminata (LPD) is a rare disease that can be challenging to diagnose. In this report, we present a case of LPD arising 5 years after laparoscopic uterine myomectomy using a power morcellator. A 32-year-old woman was admitted to our hospital with complaints of vaginal bleeding and abdominal discomfort. Five years previously, she had undergone laparoscopic uterine myomectomy using a power morcellator. Pelvic ultrasonography and magnetic resonance imaging demonstrated multiple pelvic tumors closely attached to peritoneum with no indication of malignancy. An exploratory laparotomy revealed multiple sites of leiomyomatosis in the peritoneum, especially on the parietal peritoneum at the port site of the previous laparoscopic surgery. We surgically removed all visible tumors and performed a total hysterectomy. Histologic examination confirmed the diagnosis of LPD. The use of a power morcellator without in-bag containment system might have played a role in the pathogenesis of LPD in our case. Ultrasonography, computed tomography, and MRI are among the most effective to distinguish between leiomyomas and other solid tumors in the pelvis, but they are not of great help in the differential diagnosis of malignancies. The physicians need to combine medical history, clinical findings, imaging techniques and histopathological examination to establish a correct diagnosis of LPD. The application of containment bags in the setting of power morcellation should be considered to reduce the risk of developing LPD. The optimal intervention strategy should be chosen according to the particular features of each patient. •Leiomyomatosis peritonealis disseminata (LPD) is a rare disease that can be challenging to diagnose.•The physician should suspect LPD when the woman has a history of hysterectomy or myomectomy, particularly if a power morcellator was used.•Ultrasonography, computed tomography, and MRI are among the most effective to distinguish between leiomyomas and other solid tumors in the pelvis, but they are not of great help in the differential diagnosis of malignancies.•Tumor markers such as CEA, CA19-9 and CA-125 seem not to be useful for the differential diagnosis, since LPD are sometimes associated with elevated levels of these markers.
  • Publisher: England: Elsevier Ltd
  • Language: English
  • Identifier: ISSN: 2049-0801
    EISSN: 2049-0801
    DOI: 10.1016/j.amsu.2021.102377
    PMID: 34026111
  • Source: PubMed Central
    ROAD: Directory of Open Access Scholarly Resources
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