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Disseminated peritoneal leiomyomatosis after hysterectomy: a case report
Byung-Joon Park1, Yong-Wook Kim, Lee-So Maeng
1Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Incheon St. Mary's Hospital, Incheon, Korea.
Background:
Disseminated peritoneal leiomyomatosis (DPL) is a rare disease characterized by multiple benign leiomyomas arising in the pelvic and abdominal cavities in women. DPL is observed particularly in reproductive age groups and often mimics carcinomatosis grossly, but with benign histology and a favorable prognosis. The possible causes could be divided into hormonal, subperitoneal mesenchymal stem cells, metaplasia, genetic or iatrogenic after morcellation of myoma during laparoscopic surgery. Management includes surgery followed by adjuvant hormonal therapy, systemic chemotherapy or aromatase inhibitor treatment in cases of nonresectable disease.
Case:
We report a case of DPL occurring after 2 previous operations including myomectomy and hysterectomy. After the DPL operation, the patient was treated with a gonadotropin-releasing hormone agonist for 6 months. One year after surgery, image analysis showed no evidence of disease.
Conclusion:
This rare condition must be considered even when a patient presents with abdominal masses after myomectomy followed by hysterectomy.