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

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

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