Disseminated peritoneal leiomyomatosis post-laparoscopic myomectomy

Disseminated peritoneal leiomyomatosis (DPL) is a rare benign condition in which scattered smooth muscle nodules resembling leiomyomas grow in multiple extrauterine sites within the peritoneal cavity, mimicking malignant processes like peritoneal carcinomatosis. The etiology of this condition is unclear, but it is thought to be due to either iatrogenic or hormonal factors, as studies have found that DPL is more common in females of reproductive age and in those who have undergone laparoscopic surgery with morcellation of uterine leiomyomas, as seen in the present case. Diagnostic imaging plays an important role in the preoperative diagnosis and in accurately delineating the extent of the disease. Nevertheless, histopathology remains the gold standard for a definitive diagnosis. We report a case of a 38-year-old female patient with a prior history of laparoscopic myomectomy who presented 2 years later with nonspecific left flank pain. Contrast-enhanced CT of the abdomen and pelvis and MRI revealed multiple enhancing nodular lesions scattered within the abdominal cavity. Given the prior history of laparoscopic myomectomy and radiological findings, DPL was suspected, which was confirmed later by histopathological examination.