Morcellation-Induced Leiomyomatosis Peritonealis Disseminata: A Rare Case Report

Authors

  • Alina Vitalievna Gerashchenko Department of Pathological Anatomy, Faculty of Medicine, Medical Academy Named After S.I. Georgievsky, V.I. Vernadsky Crimean Federal University, Simferopol, Russia
  • Elena Petrovna Golubinskaya Department of Pathological Anatomy, Faculty of Medicine, Medical Academy Named After S.I. Georgievsky, V.I. Vernadsky Crimean Federal University, Simferopol, Russia
  • Margarita Alexeevna Kalfa Department of Pathological Anatomy, Faculty of Medicine, Medical Academy Named After S.I. Georgievsky, V.I. Vernadsky Crimean Federal University, Simferopol, Russia
  • Maxim Andreevich Kriventsov Department of Pathological Anatomy, Faculty of Medicine, Medical Academy Named After S.I. Georgievsky, V.I. Vernadsky Crimean Federal University, Simferopol, Russia
  • Tatyana Grygorievna Filonenko Department of Pathological Anatomy, Faculty of Medicine, Medical Academy Named After S.I. Georgievsky, V.I. Vernadsky Crimean Federal University, Simferopol, Russia
Abstract:

Leiomyomatosis peritonealis disseminata (LPD) is a benign disease characterized by the presence of multiple small nodules on the omentum, parietal, and visceral peritoneum. It corresponds to leiomyoma and often resembles metastases of malignant tumors; however, with favorable prognosis. Here we describe a 46-year-old woman, diagnosed with LPD, to demonstrate the etiopathogenesis of the developed leiomyomatosis following endoscopic extirpation of the uterus with the use of a power morcellator. The patient was operated for diffuse leiomyoma using a power morcellator. Six months later, during a follow-up visit, disseminated tumor nodes on the peritoneum were revealed. Histological and immunohistochemical (smooth muscle α-actin, vimentin, estrogen receptors, progesterone receptors, and Ki67) study confirmed the diagnosis of LPD. As part of the follow-up, certain regression of the tumor nodes was noted against the backdrop of the onset of menopause and the corresponding decline of estrogen levels. Currently, the prognosis is favorable and follow-up is ongoing. Such cases are rare, but the condition is particularly important due to its iatrogenic nature. It has attracted the attention of the Food and Drug Administration (FDA) because power morcellation is probably associated with the risk of spreading suspected cancerous tissue. The existing high risk of iatrogenic LPD formation indicates the need for detailed reporting of all similar clinical cases, including the established pathogenetic and pathomorphological mechanisms of this process to prevent morcellator-related complications.

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Journal title

volume 44  issue 1

pages  60- 64

publication date 2019-01-01

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