[Diffuse peritoneal leiomyomatosis. A clinical case report]

Leiomyomatosis peritonealis disseminata (LPD) is a rare condition characterized by numerous leiomyomas throughout the peritoneal cavity which appears grossly malignant but histologically benign. LPD occurs during reproductive age, especially the third and fourth decades. The etiology of the disorders is so far unknown, but presumedly hormonal. One case of LPD is presented and discussed. The patient, a 25-year-old nulliparous woman complained of aspecific colic type abdominal pain. Pelvic examination revealed a mass of about 4 x 5 cm occupying the cul de sac. Exploratory laparatomy revealed the mass and numerous nodules on the surface of the right ovary and of the omentum. After surgery no therapy was done and follow-up was done only by ultrasound. After 4 years follow-up the patient is well and is now pregnant at the XXV week of gestation. The number of cases of LPD documented in the literature to date is only about 50 cases, but they are likely to be much more, because of many asymptomatic cases. A conservative approach is recommended, but in the last years we have always had more reports of malignant degeneration (about 10%). So when surgical castration is not possible for age and or children desire, more aggressive follow-up should be recommended. In fact recidive is so far the most unfavourable prognostic factor.