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Review Article Volume 6 Issue 1
Two cases of leiomyomatosis peritonealis disseminata and Review of the Literature
Xuechuan Han,
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Yang Fan, Yan Yu
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Department of Gynecology and Obstetrics, Ningxia People's Hospital, China
Correspondence: Xuechuan Han, Department of gynecology and obstetrics, Ningxia People's Hospital, Yin Chuan, China, Tel 860951-5920036
Received: October 16, 2016 | Published: January 12, 2017
Citation: Han X, Fan Y, Yu Y (2017) Two cases of leiomyomatosis peritonealis disseminata and Review of the Literature. Obstet Gynecol Int J 6(1): 00192. DOI: 10.15406/ogij.2017.06.00192
Abstract
Leiomyomatosis peritonealis disseminata (LPD)is an extremely rare condition. Here we present two cases of LPD in our hospital. We discuss the aetiology and treatment of this disease.
Introduction
Leiomyomatosis peritonealis disseminata (LPD) is an extremely rare condition. It is also referred to as disseminated peritoneal leiomyomatosis which is characterized by the presence of multiple peritoneal and subperitoneal nodules composed of bland smooth muscle cells. This disease was first described by Willson & Peale.1 It was designated as LPD by Taubert et al.2 It was diagnosed mainly in the reproductive-aged females. But a few cases occur in postmenopausal women and in men. Since then, less than 200 cases have been reported in the literature. Here we present two cases of LPD in our hospital.
Case series
Case 1
A 38 years old patient (granda1, para1, aborta0) admit to our hospital because of the gynecological ultrasound reveal a 5.0 cm mass in the pelvis. The patient present with no specific symptom. No abnormality was identified in the liver, spleen ultrasound. The heart and lung assessment no abnormality. In addition, cancer antigen 125 and epididymis protein 4 and alpha-fetoprotein in normal range. She underwent laparoscopical myomectomy for uterine fibroid in local hospital five years ago. During surgery a myoma with 5cm diameter was identified in the posterior uterine wall. It was removed by morcellator. The post-operative pathology reported that rich in leiomyoma cells. 2 years later she had laparoscopical hysterectomy due to the relapse of the uterine fibroid in the other hospital. During surgery two myoma was identified in the uterine. The post-operative pathology reveal that leiomyoma and positive for alpha-smooth muscle antibody and desmin. The exploratory laparotomy was performed. During surgery myoma tubercle were identified on the surface of rectum. The size was about 6cm.There were no abnormalities in the omentum, mesentery, sigmoid colon, intestine and liver. The lesion excision was performed. The frozen section indicated mesenchymal tumor. The post-operation pathology determined a diagnosis of leiomyomatosis peritonealis disseminate with no mitosis and necrosis. The result of immunohistochemistry was mostly desmin+, SMA+, ER+, PR+. The patient was uneventful and monitor by fellow up. There is no recurrence in 60months.
Case 2
A 34 years old patient (granda1, para1, aborta1) admit to our hospital because of the gynecological ultrasound reveal pelvic mass. The patient present with no specific symptom. The CA125 and epididymis protein4 was normal. She had laparotomy hysterectomy and salpino-oophorectomy in other hospital because of uterine myoma 10 years ago. The final pathology revealed uterine leiomyoma. There were no abnormality in the heart and lung. The exploratory laparotomy was carried out. In numerous leiomyoma- like implants were present in the abdomen and pelvis. There were also prominent at the surface of multiple organs including the omentum, mesentery, sigmoid colon, and intestine. The size varied from a diameter of a few millimeters (miliary seeds) to that of 6 cm. Partial omentectomy and palliative debulking of the large nodules and appendicectomy were performed. On histopathology all implanting tumors consisted predominantly of bland smooth muscle cells. On immunohistochemistry the tumor cells were mostly desmin+, SMA+, ER+, PR+. The final diagnosis was LPD. The patients was well and no recurrence in fellow up (48 months).
Acknowledgments
None.
Conflicts of interest
None.
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