Abstract:

Objective: Improve the diagnosis and treatment of leiomyomatosis peritonealis disseminate (LPD). Methods: 7 cases of LPD admitted between June 2018 and July 2021 in the Beijing Obstetrics and Gynecology Hospital of Capital Medical University were analyzed retrospectively, including their clinical characteristics, diagnosis and treatment methods, pathological diagnosis and recurrence. Results: The average age of onset of the 7 patients was 41.6 years (33-48 years). All 7 cases had a history of laparoscopic uterine myomectomy with an average of (60.1±44.6) months (range 6 to 132 months). 57.1% of patients were asymptomatic, and they presented with the main complaint of masses in the pelvic and abdominal cavity found on physical examination. Imaging mainly showed multiple solid nodules in the pelvic and abdominal cavity. The diagnostic rates of MRI and CT were 28.6% and 25.0%, respectively. All 7 patients underwent surgical treatment. Nodules extensively involved the colon mesentery (4 cases), the surface of the peritoneum (3 cases), the omentum (2 cases), Douglas pouch (2 cases), ranging from 0.4 to 10 cm in diameters. One case underwent laparoscopic total hysterectomy, double adnexectomy and resected all LPD nodules, and the remaining 6 cases done laparoscopic or laparotomy LPD nodule resection. All cases were definitive diagnosed as LPD by histopathology and immunohistochemical examination, of which 1 case was cellular uterine leiomyomas. Conclusions: LPD is a rare benign tumor, lacking specific clinical symptoms and imaging. The diagnosis mainly depends on surgery, histopathology and immunohistochemistry. The preferred treatment is surgical resection if possible, and close follow-up is required after surgery.

Key words: Peritoneal neoplasms, Leiomyomatosis, Diagnosis, Therapy, Prognosis