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CASE REPORT
Leiomyomatosis peritonealis disseminata: a rare disease with a difficult diagnosis
  1. Daniel Martins Jordão1,
  2. João Santos Pereira1,
  3. Emanuel Furtado2 and
  4. Isabel Cristina Ferrão1
  1. 1 Serviço de Cirurgia Geral, Instituto Portugues de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Portugal
  2. 2 Serviço de Cirurgia Geral, Centro Hospitalar e Universitario de Coimbra EPE Coimbra Portugal, Coimbra, Portugal
  1. Correspondence to Dr Daniel Martins Jordão, dfmjordao{at}gmail.com

Abstract

Leiomyomatosis peritonealis disseminata (LPD) is a rare condition, characterised by the proliferation of peritoneal smooth muscle nodules. LPD is a benign disease with a low rate of malignant degeneration. We describe the case of a 46-year-old, asymptomatic, woman presenting with a mass on the left renal hilum, identified by ultrasound. A CT scan showed three nodules near the left kidney, a mass anterior to the vena cava and bilateral iliac nodules. Biopsy revealed a mesenchymal low-grade tumour. The patient underwent a left nephrectomy and excision of the other masses. The histological diagnosis revealed smooth muscle nodular proliferation with no malignant features, compatible with LPD. The differential diagnosis between LPD and metastatic leiomyosarcoma is sometimes very difficult because they are clinically very similar and even on histology the diagnosis can be tricky. Treatment is conservative in most cases, with surgical excision reserved for high-risk patients.

  • carcinogenesis
  • gynecological cancer
  • general surgery
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Footnotes

  • Contributors DMJ: data acquisition, writting and review. JSP and EF: data acquisition and review. ICF: review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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