Disseminated peritoneal leiomyomatosis coexisting with leiomyoma of the uterine body

Abstract

The authors present an extremely rare case of disseminated peritoneal leiomyomatosis (DPL) coexisting with leiomyoma of the uterine body in a 32-year-old woman. The patient had undergone a caesarean section 12 years ago and used oral contraceptives since then. Before the present surgery leiomyoma of the left corner of the uterine body was diagnosed. DPL was found on the uterine serous membrane, Douglas's cavity, vesicouterine recess, the great omentum and abdominal peritoneum. There were no DPL nodules on the surface of the liver, kidneys and bowels. Saving operation was performed and only leiomyoma and the great omentum were resected. Immunohistochemical analysis using smooth muscle actin and HHF-35 antibodies showed the same reactivity of leiomyoma and DPL cells and proved the intra-operative diagnosis. Our case corroborates that DPL may occur in women of reproductive age and in patients who use oral contraceptives over a long span of time. That both leiomyoma and DPL are hormonally dependent could also be proved.