Gebreslase Musie Negasi, Reta Birhanu Kassie, Girmay Haftom Guesh, Zeray Million Abraha, Gebremariam Awash Solomon
Aksum University, College of Health Science, Department of Obstetrics and Gynecology, Aksum, Tigray, Ethiopia.
Aksum University, College of Health Science, Department of Pathology, Aksum, Tigray, Ethiopia.
Int J Surg Case Rep. 2025 Jul 26;134:111711. doi: 10.1016/j.ijscr.2025.111711.
Leiomyomatosis peritonealis disseminata (LPD) is an unusual condition characterized by the proliferation of uterine smooth muscle neoplasms onto the peritoneum and other organs in the abdomen. The cause is unknown, but it may be hormonal or uterine trauma. Most symptoms remain vague and are most common among women of reproductive age. Although they are not as common, acute presentations can include hemorrhagic features, which can lead to considerable suffering.
A 39-year-old para 1 with a history of one first-trimester spontaneous abortion presented with severe lower abdominal pain and vomiting for three days. Ultrasound imaging revealed a large intramural myoma and multiple subserosal myomas. Intraoperatively, a vascular, hemorrhagic nodular mass extending from an enlarged uterus to the peritoneum and omentum was found. Suspecting leiomyosarcoma, a hysterectomy with bilateral salpingo-oophorectomy was performed. Histopathology later confirmed LPD.
LPD is a rare benign condition mimicking malignancy, often misdiagnosed due to variable presentations. Diagnosis is usually after intraoperative evaluation. While asymptomatic cases may be monitored or treated through hormonal suppression, surgical intervention is the preferred treatment modality for symptomatic or complicated cases.
LPD is an uncommon and benign lesion that may overlap with those of malignancy, such as leiomyosarcoma, and the nonspecific features on imaging and clinical presentation make it difficult to diagnose. It is conclusively diagnosed by histopathology postoperatively. It is rare, but the possibility of recurrences and malignant transformation emphasizes the need for periodicclinical and imaging surveillance.
播散性腹膜平滑肌瘤病（LPD）是一种罕见病症，其特征为子宫平滑肌肿瘤在腹膜及腹部其他器官上增殖。病因不明，但可能与激素或子宫创伤有关。多数症状不明确，在育龄女性中最为常见。尽管并不常见，但急性表现可包括出血特征，这会导致相当大的痛苦。
一名39岁经产妇，有一次孕早期自然流产史，因严重下腹痛和呕吐三天就诊。超声检查发现一个大的肌壁间肌瘤和多个浆膜下肌瘤。术中发现一个血管丰富、出血性的结节状肿物，从增大的子宫延伸至腹膜和大网膜。怀疑为平滑肌肉瘤，遂行子宫切除术及双侧输卵管卵巢切除术。组织病理学检查后来证实为LPD。
LPD是一种罕见的良性疾病，类似恶性肿瘤，常因表现多样而被误诊。诊断通常在术中评估后做出。对于无症状病例，可通过激素抑制进行监测或治疗，而对于有症状或复杂病例，手术干预是首选的治疗方式。
LPD是一种不常见的良性病变，可能与恶性病变如平滑肌肉瘤重叠，其影像学和临床表现的非特异性特征使其难以诊断。最终通过术后组织病理学确诊。它很罕见，但复发和恶变的可能性强调了定期进行临床和影像学监测的必要性。
