Park Byung-Joon, Kim Yong-Wook, Maeng Lee-So, Kim Tae-Eung
Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Incheon St. Mary's Hospital, Incheon, Korea.
J Reprod Med. 2011 Sep-Oct;56(9-10):456-60.
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.
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.
This rare condition must be considered even when a patient presents with abdominal masses after myomectomy followed by hysterectomy.
播散性腹膜平滑肌瘤病(DPL)是一种罕见疾病,其特征为女性盆腔和腹腔内出现多个良性平滑肌瘤。DPL尤其多见于育龄期女性,大体上常酷似癌性腹膜炎,但组织学表现为良性且预后良好。其可能病因可分为激素、腹膜下间充质干细胞、化生、遗传因素或腹腔镜手术中肌瘤粉碎术后医源性因素。治疗包括手术,对于不可切除的病例,术后辅助激素治疗、全身化疗或芳香化酶抑制剂治疗。
我们报告1例在先前接受子宫肌瘤切除术和子宫切除术后发生DPL的病例。DPL手术后,患者接受促性腺激素释放激素激动剂治疗6个月。术后1年,影像分析显示无疾病迹象。
即使患者在子宫肌瘤切除术后继而子宫切除术后出现腹部肿块,也必须考虑到这种罕见疾病。