Leiomyomatosis Peritonealis Disseminata: Case Report

Abstract

Background:- Leiomyomatosis Peritonealis Disseminata (LPD) is a very rare smooth muscle tumour characterized by the dissemination of multiple smooth muscle-like nodules throughout the omental and peritoneal surfaces. Before now, no case seems to have been reported in Nigeria. It may mimic disseminated malignant peritoneal metastatic nodules. The aetiology of LPD include hormonal genetic and iatrogenic theories. Its link to estrogen/progesterone stimulation is, however, strong. Setting:-  Imo state Unversity Teaching Hospital, Orlu, Imo State, Nigeria. Case report:- A case of a 49-year-old para2 woman who presented with severe menorrhagia and dysmenorrhoea. A diagnosis of uterine leiomyoma was made for which she had Total Abdominal Hysterectomy plus Bilateral Salpingo-oophorectomy (TAH+BSO). Incidentally, during the surgery, multiple widespread leiomyoma-like nodules were noted in the peritoneal and omental surfaces. These were meticulously excised and histology report confirmed LPD. Curiously, this woman developed Non-Insulin Dependent Diabetes Mellitus about one month after surgery raising the question of whether Diabetes mellitus is a probable complication of LPD. Conclusion:- The possibility of LPD coexisting  with a fibroid riddled uterus should be borne  in mind whenever surgery is being carried out for uterine leiomyoma.