Adjuvant surgical and hormonal treatment of leiomyomatosis peritonealis disseminata. A case report.

Leiomyomatosis peritonealis disseminata (LPD) is a rare condition that usually presents during pregnancy or in women during the reproductive years and who are taking oral contraceptives. An unusual case of extensive LPD occurred in a 39-year-old woman who was not pregnant and had never taken oral contraceptives. The condition was treated successfully with total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, limited debulking and adjuvant hormonal therapy with megestrol acetate. Complete, rapid remission of residual tumor occurred in two months, as substantiated by clinical examination and serial sonography and laparoscopy. This is the first time that adjuvant hormonal therapy has been used successfully in the treatment of LPD. Radical surgery in patients with LPD is probably not indicated, and the use of adjuvant hormonal therapy may accelerate regression of residual tumor. Further evaluation of this form of therapy is recommended.