Hsieh Yun-Chiao, Kuo Po-Yen, Chiang Ying-Cheng
Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
Department of Pathology, National Taiwan University Hospital Yun-Lin Branch, Yunlin, Taiwan.
Radiol Case Rep. 2021 Nov 25;17(2):293-297. doi: 10.1016/j.radcr.2021.10.045. eCollection 2022 Feb.
Leiomyomatosis peritonealis disseminata (LPD) is a rare clinical condition characterized by the development of multiple smooth muscle-like nodules in the peritoneal or abdominal cavity. Here, we report a case of a patient who was diagnosed with LPD after laparoscopic myomectomy with power morcellation. Growing evidence has shown that LPD might develop after using power morcellation for hysterectomy or myomectomy, and this can worsen the prognosis if the spreading tissue contains malignancies, such as leiomyosarcoma. Thus, it is crucial to use laparoscopic morcellation for gynecologic procedures cautiously, and the use of a containment system is even better. If LPD develops without evidence of malignancy, the primary treatment is surgical intervention, and gonadotropin-releasing hormone agonists, aromatase inhibitors, and selective progesterone receptor modulators can be prescribed as adjuvant therapies for recurrent or refractory cases.
播散性腹膜平滑肌瘤病（LPD）是一种罕见的临床病症，其特征是在腹膜或腹腔内出现多个平滑肌样结节。在此，我们报告一例患者，该患者在腹腔镜子宫肌瘤切除术中使用动力旋切器后被诊断为LPD。越来越多的证据表明，在子宫切除术或子宫肌瘤切除术中使用动力旋切器后可能会发生LPD，如果扩散的组织含有恶性肿瘤，如平滑肌肉瘤，这会使预后恶化。因此，在妇科手术中谨慎使用腹腔镜旋切术至关重要，使用封闭系统则更佳。如果LPD在无恶性证据的情况下发生，主要治疗方法是手术干预，对于复发或难治性病例，可开具促性腺激素释放激素激动剂、芳香化酶抑制剂和选择性孕激素受体调节剂作为辅助治疗。
