Leiomyomatosis Peritonei Disseminata Following Total Abdominal Hysterectomy: A Case Report and Literature Review

Uterine leiomyoma is a benign neoplasm that arises from uterine smooth muscles and the most common tumour of the reproductive tract. Very rare leiomyomas present with unusual behavior. Disseminated peritoneal leiomyomatosis presents as multiple small nodules on the peritoneum. We present a case of Mrs. K who is a 60 years old grand multipara, ten years postmenopausal. She had total abdominal hysterectomy for multiple uterine fibroids a year earlier. Abdomino-pelvic scan and CT scan revealed a large multi lobulated heterogeneous lesion in the pelvis. The lesion measured approximately 13.5x11.5cm in size. The tumour was resected. On immunohistochemistry tumour cells were positive for alpha-smooth muscle actin, which is characteristic for smooth muscle tumour. A nuclear staining for progesterone receptor was positive, but negative for oestrogen receptors. Due to rarity of condition different modalities in the management are proposed. In view of possible recurrence and malignant transformation patients need clinical and radiological follow up? Leiomyomatosis peritonei disseminate is a rare condition. Hormonal treatment may be effective in recurrent cases especially in hormone receptor positive tumor or when temporary relief of symptoms is necessary.