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[DISSEMINATED PERITONEAL LEYOMYOMATOSIS AFTER LAPAROSCOPIC MORCELLATION--A CASE REPORT]
Akusherstvo I Ginekologiia
|August 13, 2016
Summary
Disseminated peritoneal leiomyomatosis is a rare condition that can occur after laparoscopic surgery, particularly following myomectomy with morcellation. This case highlights the importance of considering this diagnosis in patients with suspected malignancy after prior laparoscopic procedures.
Area of Science:
- Gynecology
- Surgical Pathology
Background:
- Disseminated peritoneal leiomyomatosis (DPL) is a rare condition characterized by the widespread growth of benign smooth muscle tumors throughout the peritoneum.
- While historically uncommon, DPL has seen increased reporting in recent years, potentially linked to the rise of laparoscopic surgical techniques.
Observation:
- A 41-year-old patient presented with suspected necrotic leiomyoma, necessitating a laparotomy after two prior laparoscopic myomectomies.
- Intraoperative findings initially suggested disseminated malignancy.
- Subsequent histological and immunohistochemical analysis of the resected tissue confirmed disseminated peritoneal leiomyomatosis.
Findings:
- The patient underwent a total hysterectomy with right adnexectomy and total omentectomy.
- Post-operative examination revealed benign smooth muscle tumors, ruling out malignancy.
- The final diagnosis was disseminated peritoneal leiomyomatosis.
Implications:
- This case underscores the potential for benign smooth muscle tumors to disseminate following laparoscopic procedures, particularly those involving morcellation.
- Accurate histological and immunohistochemical evaluation is crucial for differentiating DPL from malignancy.
- Awareness of DPL is important for surgeons performing gynecological laparoscopic procedures, especially myomectomies.
