Disseminated Peritoneal Leiomyomatosis: An Unusual Complication of Laparoscopic Myomectomy

Abstract

Disseminated Peritoneal Leiomyomatosis (DPL) is characterised by multiple smooth muscle tissues over the peritoneal surface of the pelvic and abdominal cavity. Possible causes of DPL include hormonal factors, subperitoneal mesenchymal stem cell metaplasia, genetic factors, or iatrogenic factors. Hereby, the authors represents a case of DPL in a 42-year-old female with a history of two Laparoscopic Myomectomies. She presented with complaints of abdominal distension and bilateral lower limb pain lasting eight months. She underwent a robotic hysterectomy with bilateral salpingectomy and the removal of intraperitoneal nodules. Intraoperative findings showed a mass resembling leiomyoma over the uterus, mesentery, spleen, and rectosigmoid. She was discharged on postoperative day 4 and has been asymptomatic for the past two years. Robotic surgery is an emerging surgical modality in the treatment of DPL due to its better precision and ease of accessibility to upper abdominal organs. More importantly, recovery time is enhanced, and it reduces the duration of hospital stay.

Keywords

• hepatosplenomegaly
• intraperitoneal nodules
• leiomyoma
• power morcellation