Introduction/Background Disseminated peritoneal leiomyomatosis (DPL) is a rare disease characterized by the presence of multiple nodules of smooth muscle cells dispersed in the abdominal cavity. To date, only about 150 cases have been reported in the literature. We present a case of recurrent DPL after laparotomy in a 45-year-old patient treated at San Jose Hospital, in the city of Bogotá, Colombia.
Methodology We describe a clinical case of a 45-year-old woman with abnormal uterine bleeding, who was taken to total abdominal hysterectomy in November 2010, with a report of pathology with intramural and cervical myomatosis. Subsequently, in 2013, she was taken again to surgical procedure, performing ovarian cystectomy + partial omentectomy + appendectomy, with pathology report leiomyoma, benign stromal tumor and omentum with disseminated peritoneal leiomyomatosis and negative appendix for neoplasia. Due to the persistence of abdominal pain associated with mass, imaging is performed, including a total abdominal ultrasound, Tomography and Nuclear Magnetic Resonance, which reported multiple pelvic masses, compatible with disseminated peritoneal leiomyomatosis, which led to ultraradical surgery in our institution. July 2018, with complete cytoreduction of the lesions and adequate postoperative evolution, who to date has remained without recurrence of the disease.
Results The differential diagnosis of DPL is a challenge due to its similarity with peritoneal carcinomatosis and other benign abdominal disorders. Malignant transformation is rare, but it can happen, so a close follow-up is necessary. In our literature review we found reports from 1976 to 2017, approximately 150 cases had been reported in the literature.
Conclusion DPL is a rare but potentially serious disease. In our opinion, larger studies are needed to improve our diagnostic effectiveness and define the best therapeutic strategy. The different studies show that surgical treatment is the first option in women without reproductive desire or postmenopausal women.
Disclosure Nothing to disclose.
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