Department of Gynecology, Hwa Mei Hospital of University of Chinese Academy of Sciences, Ningbo, China.
Department of Gynecologic Oncology, Cancer Hospital of University of Chinese Academy of Sciences, China.
Medicine (Baltimore). 2022 Sep 9;101(36):e30528. doi: 10.1097/MD.0000000000030528.
Leiomyomatosis peritonealis disseminata (LPD) is a rare disease characterized by multiple leiomyomas spread all over the peritoneal cavity. It is commonly described as benign in women of reproductive age. Malignant LPD is much rarer.
We present a case of LPD with low potential malignant change in a 43-year-old female, who felt a lump in her abdomen after laparoscopic myomectomy 10 years ago and laparoscopic hysterectomy 8 years ago. The patient underwent exploratory laparotomy and salpingectomy, greater omentectomy, and pelvic and abdominal mass resection were performed during the surgery. The pathological findings revealed LPD with low potential malignant change, with strong expression of estrogen receptor and progesterone receptor. The patient refused oophorectomy and chose gonadotropin-releasing hormone agonists injection postoperatively.
No recurrence was found during the follow-up to date.
Surgery is the main treatment for LPD, and endocrine therapy is another choice. Although it is reported mostly benign, we need to be alert to the possibility of malignancy.
播散性腹膜平滑肌瘤病（LPD）是一种罕见疾病，其特征是多发性平滑肌瘤广泛分布于整个腹膜腔。在育龄妇女中，它通常被描述为良性。恶性 LPD 则更为罕见。
我们报告了一例低潜在恶性变化的 LPD 病例，患者为 43 岁女性，10 年前行腹腔镜子宫肌瘤剔除术后和 8 年前行腹腔镜子宫切除术时，自觉腹部有肿块。患者接受了剖腹探查术，术中进行了输卵管切除术、大网膜切除术以及盆腔和腹部肿块切除术。病理结果显示为低潜在恶性变化的 LPD，雌激素受体和孕激素受体表达较强。患者拒绝行卵巢切除术，术后选择了促性腺激素释放激素激动剂注射。
随访至今未发现复发。
手术是 LPD 的主要治疗方法，内分泌治疗是另一种选择。尽管它大多被报道为良性，但我们需要警惕恶性的可能性。
