Lee Woo Yong, Noh Ji Hyun
Department of Surgery, Seoul Paik Hospital, Inje University College of Medicine, 9, Mareunnae-ro, Jung-gu, Seoul, 100-032, Korea.
Department of Obstetrics and Gynecology, Ilsan Paik Hospital, Inje University College of Medicine, 170, Juhwaro, Ilsanseogu, Gyeonggido, 411-706, Korea.
J Med Case Rep. 2015 Jul 28;9:167. doi: 10.1186/s13256-015-0637-1.
Leiomyomatosis peritonealis disseminata is a very rare benign condition of the peritoneal cavity that may mimic peritoneal carcinomatosis or metastatic leiomyosarcomas. It mainly develops in association with pregnancy, but is also rarely associated with endometriosis.
A 31-year-old Asian woman presented to our hospital with abdominal pain in the right lower quadrant. Her abdominopelvic computed tomography scan showed a 1.2cm-sized nodule at the appendiceal tip, but no other abnormal findings. We suspected acute appendicitis and performed an exploratory laparoscopy. Her appendix was enlarged at the tip portion. Also noted were blood-colored fluid collections in her pelvic cavity and bilateral ovarian cysts. Additionally, several small whitish firm solid nodules, ranging from 0.5 to 1.0cm in size, were present on her pelvic peritoneum. Her histological examination confirmed that the endometriosis of her appendix coexisted with leiomyomatosis peritonealis disseminata.
We report a case involving a 31-year-old woman with acute symptoms of endometriosis of the appendix associated with leiomyomatosis peritonealis disseminata. Appendiceal endometriosis with leiomyomatosis peritonealis disseminata presenting as acute appendicitis is extremely rare. To the best of our knowledge, this is the first such case reported in the literature.
播散性腹膜平滑肌瘤病是一种非常罕见的腹膜腔良性疾病，可能酷似腹膜癌或转移性平滑肌肉瘤。它主要在妊娠期间发生，但也很少与子宫内膜异位症相关。
一名31岁的亚洲女性因右下腹痛前来我院就诊。她的腹部盆腔计算机断层扫描显示阑尾尖端有一个1.2厘米大小的结节，但无其他异常发现。我们怀疑是急性阑尾炎并进行了 exploratory laparoscopy（此处原文有误，推测可能是“exploratory laparotomy”，即剖腹探查术）。她的阑尾尖端肿大。还注意到盆腔内有血性液体聚集以及双侧卵巢囊肿。此外，在她的盆腔腹膜上有几个大小从0.5到1.0厘米不等的白色坚实小结节。她的组织学检查证实阑尾子宫内膜异位症与播散性腹膜平滑肌瘤病并存。
我们报告了一例涉及一名31岁女性的病例，该女性患有与播散性腹膜平滑肌瘤病相关的阑尾子宫内膜异位症急性症状。以急性阑尾炎形式出现的阑尾子宫内膜异位症合并播散性腹膜平滑肌瘤病极为罕见。据我们所知，这是文献中首次报道的此类病例。
