Article Data

  • Views 463
  • Dowloads 156

Case Reports

Open Access

Large leiomyomatosis peritonealis disseminata with ascites and pleural effusion eight years after laparoscopic supracervical hysterectomy: an extremely rare case and review of literature

  • Hong-Yan Chen1,*,
  • Dong-Lan Lei1
  • Jin-lian Huang1

1Department of Obstetrics and Gynecology, Hengzhou People’s Hospital, Hengzhou City of Nanning, 530300 Hengzhou, Guangxi, China

DOI: 10.22514/ejgo.2024.039 Vol.45,Issue 2,April 2024 pp.163-168

Submitted: 13 August 2022 Accepted: 18 November 2022

Published: 15 April 2024

*Corresponding Author(s): Hong-Yan Chen E-mail:


Leiomyomatosis peritonealis disseminata is a rare benign disease characterized by the appearance of multiple pelvic and abdominal nodules. Its pathogenesis remains unclear and preoperative diagnosis is difficult. Here, we report a case of Leiomyomatosis peritonealis disseminata in a 48-year-old woman with post-polio paralysis and complaints of lower abdominal distending pain. Eight years ago, she underwent a laparoscopic supracervical hysterectomy with electronic power morcellator without an in-bag containment system. Medical imaging showed unilateral pleural effusion, a small amount of ascites and a large cystic-solid mass that filled the pelvis and abdomen, measuring 25 cm in size, following which she underwent bilateral adnexectomy, omentectomy, residual cervical resection and removal of all visible lesions. Histopathology confirmed the diagnosis of Leiomyomatosis peritonealis disseminata. To our best knowledge, large Leiomyomatosis peritonealis disseminata with ascites and pleural effusion has not been previously reported in literature. Our study showed that the patient was disease-free without any evidence of recurrence for over half a year after surgery, suggesting that the surgical resection of the tumors and bilateral adnexal was an effective and reasonable treatment. These observations suggest that more consideration should be given to Leiomyomatosis peritonealis disseminata after laparoscopic myomectomy or supracervical hysterectomy with power morcellation.


Leiomyomatosis peritonealis disseminata; Power morcellation; Leiomyoma; Ascites; Pleural effusion

Cite and Share

Hong-Yan Chen,Dong-Lan Lei,Jin-lian Huang. Large leiomyomatosis peritonealis disseminata with ascites and pleural effusion eight years after laparoscopic supracervical hysterectomy: an extremely rare case and review of literature. European Journal of Gynaecological Oncology. 2024. 45(2);163-168.


[1] H.D. Taubert, S.E. Wissner, A.L. Haskins. Leiomyomatosis peritonealis disseminata; an unusual complication of genital leiomyomata. Obstetrics and Gynaecology. 1965; 25: 561–574.

[2] Al-Talib A, Tulandi T. Pathophysiology and possible iatrogenic cause of leiomyomatosis peritonealis disseminata. Gynecologic and Obstetric Investigation. 2010; 69: 239–244.

[3] Lu B, Xu J, Pan Z. Iatrogenic parasitic leiomyoma and leiomyomatosis peritonealis disseminata following uterine morcellation. Journal of Obstetrics and Gynaecology Research. 2016; 42: 990–999.

[4] Nappi L, Sorrentino F, Angioni S, Pontis A, Barone I, Greco P. Leiomyomatosis peritonealis disseminata (LPD) ten years after laparoscopic myomectomy associated with ascites and lymph nodes enlargement: a case report. International Journal of Surgery Case Reports. 2016; 25: 1–3.

[5] Agha RA, Franchi T, Sohrabi C, Mathew G, Kerwan A, Thoma A, et al. The SCARE 2020 guideline: updating consensus surgical case report (SCARE) guidelines. International Journal of Surgery. 2020; 84: 226–230.

[6] P. Rubisz, M. Ciebiera, L. Hirnle, M. Zgliczynska, T. Lozinski, P. Dziegiel, et al. The usefulness of immunohistochemistry in the differential diagnosis of lesions originating from the myometrium. International Journal of Molecular Sciences. 2019; 20: 1136.

[7] D. Petrovic, D. Babic, J.I. Forko, I. Martinac. Expression of Ki-67, P53 and progesterone receptors in uterine smooth muscle tumors. Diagnostic value. Collegium Antropologicum. 2010; 34: 93–97.

[8] S. Soni, P. Pareek, S. Narayan. Disseminated peritoneal leiomyomatosis: an unusual presentation of intra-abdominal lesion mimicking disseminated malignancy. Medicine and Pharmacy Reports. 2020; 93:113-116.

[9] Syed M, Parida B, Mankeshwar T, Patil A. Imaging findings in a rare case of leiomyomatosis peritonealis disseminata with malignant transformation. Polish Journal of Radiology. 2017; 82: 426–430.

[10] R. Agrawal, M. Kumar, L. Agrawal, K.K. Agrawal. A huge primary ovarian leiomyoma with degenerative changes-an unusual. Journal of Clinical and Diagnostic Research. 2013; 7: 1152–1154.

[11] Ferrario L, Zerbi P, Angiolini MR, Agarossi A, Riggio E, Bondurri A, et al. Leiomyomatosis peritonealis disseminata: a case report of recurrent presentation and literature review. International Journal of Surgery Case Reports. 2018; 49: 25–29.

[12] M. Onorati, G. Petracco, P. Uboldi, S. Romagnoli, M.M. Amidani, G. Bulfamante, et al. Leiomyomatosis peritonealis disseminata: pregnancy, contraception and myomectomy of its pathogenesis. Pathologica. 2013; 105:107–109.

[13] F. Kouakou, R. Adjoby, D. Gondo, V. Loue, K. N'Guessan, A. Kouame, et al. Leiomyomatosis peritonealis disseminata and pregnancy: a case report. Clinical and Experimental Obstetrics & Gynecology. 2012; 39: 541–543.

[14] Li J, Dai S. Leiomyomatosis peritonealis disseminata: a clinical analysis of 13 cases and literature review. International Journal of Surgical Pathology. 2020; 28: 163–168.

[15] Yu R, Wang Z, Sun J, Chen L. Computed tomography of pancreatic implantation with malignant transformation of leiomyomatosis peritonealis disseminata in a man. Digestive Diseases and Sciences. 2007; 52: 1954–1957.

[16] Huang S, Wen C, Liao C, Lin J, Tsai C. Leiomyomatosis peritonealis disseminata mimicking peritoneal carcinomatosis 13 years after laparoscopic uterine myomectomy: a case report. International Journal of Surgery Case Reports. 2021; 81: 105745.

[17] X. Chen, H. Liu, H. Shi, Q. Fan, D. Sun, J. Lang. Leiomyomatosis peritonealis disseminata following laparoscopic surgery with uncontained morcellation: 13 cases from one institution. Frontiers in Surgery. 2021; 8: 788749.

[18] Hsieh Y, Kuo P, Chiang Y. Leiomyomatosis peritonealis disseminata in laparoscopic port site and abdomino-pelvic cavity: a case report. Radiology Case Reports. 2022; 17: 293–297.

[19] Van der Meulen J, Pijnenborg J, Boomsma C, Verberg M, Geomini P, Bongers M. Parasitic myoma after laparoscopic morcellation: a systematic review of the literature. BJOG: An International Journal of Obstetrics & Gynaecology. 2016; 123: 69–75.

[20] FDA. Quantitative assessment of the prevalence of unsuspected uterine sarcoma in women undergoing treatment of uterine fibroids. 2014.

[21] Krentel H, Wilde RLD. Laparoscopic supracervical hysterectomy with in-bag morcellation in very large uterus. Case Reports in Medicine. 2017; 2017: 1–5.

[22] Won YB, Lee HJ, Eoh KJ, Chung YS, Lee YJ, Park SH, et al. In-bag power morcellation technique in single-port laparoscopic myomectomy. Obstetrics & Gynecology Science. 2018; 61: 267.

[23] Clark LE, Menderes G, Tower AM, Silasi D, Azodi M. A simple approach to specimen retrieval via posterior colpotomy incision. JSLS: Journal of the Society of Laparoendoscopic Surgeons. 2015; 19: e2015.00222.

[24] Paul P, Shintre H, Mehta S, Gulati G, Paul G, Mannur S. Parasitic myomas: an unusual risk after morcellation. Gynecology and Minimally Invasive Therapy. 2018; 7: 124.

[25] Yu SP, Lee BB, Han MN, Chan C, Rao J, Levin M, et al. Irrigation after laparoscopic power morcellation and the dispersal of leiomyoma cells: a pilot study. Journal of Minimally Invasive Gynecology. 2018; 25: 632–637.

[26] Darii N, Anton E, Doroftei B, Ciobica A, Maftei R, Anton SC, et al. Iatrogenic parasitic myoma and iatrogenic adenomyoma after laparoscopic morcellation: a mini-review. Journal of Advanced Research. 2019; 20: 1–8.

[27] Yoshino Y, Yoshiki N, Nakamura R, Iwahara Y, Ishikawa T, Miyasaka N. Large leiomyomatosis peritonealis disseminata after laparoscopic myomectomy: a case report with literature review. International Journal of Surgery Case Reports. 2020; 77: 866–869.

[28] S. Kumar, J.B. Sharma, D. Verma, P. Gupta, K.K. Roy, N. Malhotra. Disseminated peritoneal leiomyomatosis: an unusual complication of laparoscopic myomectomy. Archives of Gynecology and Obstetrics. 2008; 278: 93–95.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Submission Turnaround Time