Leiomyomatosis peritonealis disseminata with malignant change in a post-menopausal woman

Leiomyomatosis peritonealis disseminata (LPD) is a rare condition characterized by multiple subperitoneal nodules of benign smooth muscle. The lesion usually occurs in women of childbearing age.

A 55-year-old woman with a history of panhysterectomy 8 years ago presented with an abdominal lump. Ultrasonographic and peroperative finding of multiple omental nodules led to a clinical impression of disseminated malignancy. Only the largest nodule was excised, histopathology of which revealed a cellular leiomyoma. Seven months later, she developed an omental leiomyosarcoma. An omentectomy was done and the multiple smaller nodules were all confirmed to be composed of benign leiomyocytes.

Malignant transformation in LPD in post-menopausal patients is an exceptional event that has been documented only twice previously in English literature.