A Rare Case of Leiomyomatosis Peritonalis Disseminata
Chijioke O. Ezeigwe
Department of Obstetrics and Gynaecology, College of Health Sciences, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria.
Uchenna D. Okudo
Department of Public Health, Ulster University, Belfast, United Kingdom.
Onyeka C. Ekwebene
Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, Tennessee, USA.
Emmanuel C. Egwuatu
Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.
Daniel C. Anyiam
Department of Anatomic Pathology/Forensic Medicine, College of Health Sciences, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria.
Jerome C. Okudo *
Department of Public Health, University of Texas, Houston, USA.
Oyetokunbo Ibidapo-Obe
Department of Family Medicine, The University of Texas Medical Branch, Galveston, TX, USA.
George U. Eleje
Department of Obstetrics and Gynaecology, College of Health Sciences, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria.
Charlotte B. Oguejiofor
Department of Obstetrics and Gynaecology, College of Health Sciences, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria.
Nkejesus C. Obi
Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.
Victor K. Nwodo
Department of Radiography and Radiological Science, College of Health Sciences, Nnamdi Azikiwe University, Nnewi campus, Anambra State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Leiomyomatosis Peritonalis Disseminata (LPD), also known as disseminated peritoneal leiomyomatosis is an extremely rare disease in women and men where there is a rapid increase in peritoneal and subperitoneal nodules mainly of smooth muscle cells. It is a benign condition, however, its diagnosis can mimic or degenerate into peritoneal leiomyosarcoma, making the diagnosis tricky. In addition, clinical manifestations can be very nonspecific.
We discuss the case of a 38-year-old nulliparous patient who presented to the clinic with a 2-year history of lower abdominal swelling and a 5-month history of severe menorrhagia. Intraoperative findings showed an enlarged uterus with subserosal fibroids and several deposits on the serosa and intestines. The patient had Total hysterectomy and bilateral-salpingoophorectomy. Because malignant transformation has been reported to potentially occur almost 10 years from initial diagnosis, patients should be monitored by repeat ultrasound scans.
Keywords: Leiomyomatosis peritonalis disseminata, subserosal fibroids, malignant transformation, estrogen