Leiomyomatosis peritonealis disseminata

Leiomyomatosis peritonealis disseminata (LPD) is a benign entity in which numerous small grey-white nodules consisting of smooth-muscle cells are found scattered in the peritoneal cavity. LPD has only been found in women, predominantly in their late reproductive age. It has, with a few exceptions, been asymptomatic and is most often an incidental finding at laparotomy performed in order to excise a leiomyomatous uterus or during Caesarean section. Although the disorder is rare, it is alarming to the surgeon, who may be faced unexpectedly with it peroperatively. Since it is grossly indistinguishable from diffuse carcinomatosis of the peritoneum, several unnecessary radical procedures have resulted. We report a case in which not only the gross-pathological features found during surgery, but also the clinical course, as well as the preoperative investigations were highly suggestive of frank malignancy. A survey of the literature is also presented. It is emphasized that in all cases regression has occurred regardless of the therapeutic action taken.