AlAtrash Ziyad Fathi, Eljabu Najwa Basher
University of Tripoli, Faculty of Medicine, Tripoli, Libya.
Consultant at Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tripoli, Libya.
Int J Surg Case Rep. 2025 Mar;128:111025. doi: 10.1016/j.ijscr.2025.111025. Epub 2025 Feb 7.
Leiomyomatosis peritonealis disseminata is a very rare disease that involves the presence of multiple benign tumors of smooth muscle origin all over the peritoneal cavity. Due to its ability to mimic malignant pathologies, it is associated with significant diagnostic and therapeutic challenges. This case highlights a unique case of LPD to further raise awareness and provide useful information on how to manage this condition.
A 28-year-old female was admitted with progressive increase in abdominal distension and discomfort. Imaging studies revealed multiple peritoneal nodules that mimicked metastatic disease. Laparoscopic exploration and histopathological examination subsequently confirmed the diagnosis of LPD. She never had a history of malignancy and hormonal therapy, which are the usual associations with this condition.
Diagnosis of LPD is usually missed because its clinically and radiologically smoky appearance of the belly may mimic peritoneal carcinomatosis. Pathogenesis includes hormonal factors, though rare cases are idiopathic. Symptomatic nodules are usually treated with surgical excision and in recurrent cases, attempts at hormonal manipulation can be done.
This case shows the inclusion of LPD in the differential diagnosis of peritoneal masses is of paramount importance, especially in women of childbearing age. Early and accurate diagnosis will help in avoiding the unnecessary aggressive measures.
播散性腹膜平滑肌瘤病是一种非常罕见的疾病,其特征是在整个腹腔内存在多个平滑肌来源的良性肿瘤。由于它能够模仿恶性病变,因此在诊断和治疗方面面临重大挑战。本病例突出了一个独特的播散性腹膜平滑肌瘤病病例,以进一步提高认识,并提供有关如何处理这种疾病的有用信息。
一名28岁女性因腹胀和不适逐渐加重入院。影像学检查发现多个腹膜结节,疑似转移性疾病。随后通过腹腔镜探查和组织病理学检查确诊为播散性腹膜平滑肌瘤病。她既往无恶性肿瘤病史及激素治疗史,而这些通常与该病相关。
播散性腹膜平滑肌瘤病的诊断通常会被漏诊,因为其腹部在临床和影像学上的模糊表现可能会模仿腹膜癌。发病机制包括激素因素,不过少数病例为特发性。有症状的结节通常采用手术切除治疗,对于复发病例,可以尝试进行激素调控。
本病例表明,将播散性腹膜平滑肌瘤病纳入腹膜肿块的鉴别诊断至关重要,尤其是在育龄女性中。早期准确诊断有助于避免不必要的激进治疗措施。