Leiomyomatosis peritonealis disseminata associated with large uterine myoma without history of surgery: A case report and review of literature.

Abstract: Leiomyomatosis peritonealis disseminata (LPD) is a rare benign disease characterized by multiple smooth muscle nodules disseminated on the omental and peritoneal surfaces. Its pathogenesis remains unknown. Parasitic LPD is thought to result from uterine myoma surgery and myoma morcellation. Here, we report the first case of LPD associated with a large uterine myoma without a history of surgery. A 47-year-old woman presented with abdominal distension and a palpable abdominal mass at an outpatient clinic. During surgery, a myoma of approximately 30 cm and multifocal myofibroblastic tissue spreading on the omentum, which was compressed by uterine myoma, were observed. The patient underwent a total hysterectomy and omental resection. The pathological examination confirmed the diagnosis of LPD. This report reveals that LPD can be detected in a patient with a large uterine myoma that developed in a nulligravida woman who was not administered exogenous hormones and had no history of uterine surgery. Therefore, we should examine the intraperitoneal cavity closely to identify LPD during large myoma surgeries.