Disseminated peritoneal leiomyomatosis after uterine artery embolization, laparoscopic surgery, and high intensity focused ultrasound for uterine fibroids：a case report

Abstract

Background Disseminated peritoneal leiomyomatosis (DPL) is a rare, generally benign disorder. With the advent of laparoscopic surgery for uterine fibroids, the reported number of cases of DPL has significantly increased since the introduction of unconfined power morcellation. Morcellation and other procedures may be associated with DPL. Methods We present the case of a 48-year-old patient with DPL who underwent uterine artery embolization (UAE), laparoscopic myomectomy and high intensity focused ultrasound (HIFU) 11 years, 6 years, and 2 years before the final diagnosis of DPL was made. A subtotal hysterectomy with bilateral salpingo-oopherectomy was performed to remove the uterus, the fallopian tube and the ovaries. We carefully excised as many visible lesions as possible. Results After the surgical treatment performed in our center the patient became free of symptoms. Conclusion In our case, the occurrence of DPL is most likely associated with laparoscopic myomectomy using power morcellation. In addition, it should be noted whether some other factors played a role in stimulating the growth of the multiple nodules.