E-ISSN: 2619-9467

Contents    Cover    Publication Date: 18 Jan 2022
Year 2021 - Volume 31 - Issue 4

Open Access

Peer Reviewed

CASE REPORTS
930 Viewed865 Downloaded

Disseminated Peritoneal Leiomyomatosis with Uterine Smooth Muscle Tumors of Uncertain Malignant Potential After Morcellator

Full Text PDF  
JCOG. 2021;31(4):133-6
DOI: 10.5336/jcog.2021-86285
Article Language: EN
Copyright Ⓒ 2020 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Disseminated peritoneal leiomyomatosis (DPL) are characterized by the dissemination of smooth muscle nodules throughout the peritoneal surfaces. Smooth uterine muscle tumors of uncertain malignant potential (STUMP) is also a rare situation with complicated diagnosis and treatment with similar disease presentation to DPL. Interventional procedure such as laparoscopic morcellation can disseminate small tumor pieces all around the abdominal cavity. The objective of this study is to evaluate whether imminent follow-ups are needed after laparoscopic surgeries such as morcellation to reduce disease recurrence. We discuss the case of a 43-years-old patient presented with abdominal pain who had laparoscopic myomectomy 2 years ago. A uterine mass was noted with ultrasonography and computed tomography. The pathological results of masses was reported as STUMP. For both DPL and STUMP, diagnosis and treatments are difficult and problematic. This emphasizes the importance of following up with patients after laparoscopic surgeries, especially after morcellation.
REFERENCES:
  1. Paul PG, Naik S. Disseminated leiomyomatosis peritonei. Incidental finding in laparoscopy: a case report. Surg Laparosc Endosc Percutan Tech. 2010;20(3):e123-4. [Crossref]  [PubMed] 
  2. Gaichies L, Fabre-Monplaisir L, Fauvet R, Alves A, Mulliri A. Leiomyomatosis peritonealisis disseminata: Two unusual cases with literature review. J Gynecol Obstet Hum Reprod. 2018;47(2):89-94. [Crossref]  [PubMed] 
  3. Wu C, Zhang X, Tao X, Ding J, Hua K. Leiomyomatosis peritonealis disseminata: A case report and review of the literature. Mol Clin Oncol. 2016;4(6):957-8. [Crossref]  [PubMed]  [PMC] 
  4. Rosenbaum L. N-of-1 Policymaking--Tragedy, Trade-offs, and the Demise of Morcellation. N Engl J Med. 2016;374(10):986-90. [Crossref]  [PubMed] 
  5. Kumar S, Sharma JB, Verma D, Gupta P, Roy KK, Malhotra N. Disseminated peritoneal leiomyomatosis: an unusual complication of laparoscopic myomectomy. Arch Gynecol Obstet. 2008;278(1):93-5. [Crossref]  [PubMed] 
  6. Tun AM, Tun NM, Zin Thein K, Naing EE, Giashuddin S, Shulimovich M. A rare concurrence of leiomyomatosis peritonealis disse minata, leiomyosarcoma of the pelvis and leiomyomatous nodule of the liver. Case Rep Oncol Med. 2016;2016:3025432. [Crossref]  [PubMed]  [PMC] 
  7. Ip PP, Cheung AN. Pathology of uterine leiomyosarcomas and smooth muscle tumours of uncertain malignant potential. Best Pract Res Clin Obstet Gynaecol. 2011;25(6): 691-704. [Crossref]  [PubMed] 
  8. Bell SW, Kempson RL, Hendrickson MR. Problematic uterine smooth muscle neoplasms. A clinicopathologic study of 213 cases. Am J Surg Pathol. 1994;18(6):535-58. [Crossref]  [PubMed] 
  9. Esposito NN, Hunt JL, Bakker A, Jones MW. Analysis of allelic loss as an adjuvant tool in evaluation of malignancy in uterine smooth muscle tumors. Am J Surg Pathol. 2006;30(1):97-103. [Crossref]  [PubMed] 
  10. George S, Barysauskas C, Serrano C, Oduyebo T, Rauh-Hain JA, Del Carmen MG, et al. Retrospective cohort study evaluating the impact of intraperitoneal morcellation on outcomes of localized uterine leiomyosarcoma. Cancer. 2014;120(20):3154-8. [Crossref]  [PubMed] 
  11. Kurman RJ, Ronnett BM. Blaustein's Pathology of the Female Genital Tract. 6th ed. Boston: Springer New York Dodrecht Heidelberg London; 2011. [Crossref] 
  12. Seidman MA, Oduyebo T, Muto MG, Crum CP, Nucci MR, Quade BJ. Peritoneal dissemination complicating morcellation of uterine mesenchymal neoplasms. PLoS One. 2012;7(11): e50058. [Crossref]  [PubMed]  [PMC] 
  13. Oduyebo T, Rauh-Hain AJ, Meserve EE, Seidman MA, Hinchcliff E, George S, et al. The value of re-exploration in patients with inadvertently morcellated uterine sarcoma. Gynecol Oncol. 2014;132(2):360-5. [Crossref]  [PubMed] 
  14. Mowers EL, Skinner B, McLean K, Reynolds RK. Effects of morcellation of uterine smooth muscle tumor of uncertain malignant potential and endometrial stromal sarcoma: case series and recommendations for clinical practice. J Minim Invasive Gynecol. 2015;22(4):601-6. [Crossref]  [PubMed] 
  15. Vilos GA, Marks J, Ettler HC, Vilos AG, Prefontaine M, Abu-Rafea B. Uterine smooth muscle tumors of uncertain malignant potential: diagnostic challenges and therapeutic dilemmas. Report of 2 cases and review of the literature. J Minim Invasive Gynecol. 2012; 19(3):288-95. [Crossref]  [PubMed]