Bucuri Carmen Elena, Ciortea Razvan, Malutan Andrei Mihai, Oprea Valentin, Toma Mihai, Roman Maria Patricia, Ormindean Cristina Mihaela, Nati Ionel, Suciu Viorela, Simon-Dudea Marina, Mihu Dan
2nd Department of Obstetrics and Gynaecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania.
Clinical Department of Surgery, "Constantin Papilian" Emergency Clinical Military Hospital, 22 G-ral Traian Mosoiu, 400132 Cluj-Napoca, Romania.
Biomedicines. 2024 Aug 3;12(8):1749. doi: 10.3390/biomedicines12081749.
Disseminated peritoneal leiomyomatosis (DPL) is a rare condition marked by multiple leiomyomas in the peritoneal cavity, predominantly affecting women of reproductive age. Although typically benign, DPL can present significant diagnostic challenges and, in rare cases, may progress to malignancy. A primary contributing factor to DPL is iatrogenic, particularly due to surgical interventions such as morcellation during myomectomy. This scoping review explores the pathogenesis, epidemiology, diagnosis, and management of DPL, highlighting the crucial role of hormonal influences and iatrogenic factors. Diagnostic methods include computed tomography, ultrasound, magnetic resonance imaging, and histopathological evaluation, which are essential for assessing disease extent and guiding treatment. Management strategies encompass surgical intervention-with a focus on minimizing iatrogenic risks-conservative approaches for asymptomatic patients, and advancements in hormonal treatments. Emphasis is placed on preventing iatrogenic dissemination through refined surgical techniques and patient education. Despite its rarity, with fewer than 200 cases reported globally, understanding DPL's clinical presentation and iatrogenic origins is vital for optimal patient outcomes. This review underscores the importance of early diagnosis, personalized treatment plans, and ongoing research to address the challenges associated with DPL.
播散性腹膜平滑肌瘤病（DPL）是一种罕见疾病，其特征为腹腔内出现多个平滑肌瘤，主要影响育龄女性。尽管DPL通常为良性，但它可能带来重大的诊断挑战，在极少数情况下还可能进展为恶性肿瘤。DPL的一个主要促成因素是医源性的，尤其是由于诸如子宫肌瘤切除术中碎瘤术等手术干预。本范围综述探讨了DPL的发病机制、流行病学、诊断和管理，强调了激素影响和医源性因素的关键作用。诊断方法包括计算机断层扫描、超声、磁共振成像和组织病理学评估，这些对于评估疾病范围和指导治疗至关重要。管理策略包括手术干预——重点是将医源性风险降至最低——对无症状患者采取保守方法，以及激素治疗方面的进展。重点是通过改进手术技术和患者教育来预防医源性播散。尽管DPL罕见，全球报告的病例不到200例，但了解其临床表现和医源性起源对于实现最佳患者预后至关重要。本综述强调了早期诊断、个性化治疗方案以及持续研究以应对与DPL相关挑战的重要性。
