Leiomyomatosis peritonealis disseminata in postmenopausal women: a case report with review of literature

BACKGROUND: Leiomyomatosis peritonealis disseminata is an exceedingly rare benign disorder characterized by multiple vascular leiomyomas growing along the submesothelial tissues of the abdominopelvic peritoneum. It is commonly described in women of reproductive age and is rarely seen in men and postmenopausal women. CASE DETAILS: A 65-year-old female patient with a history of abdominal surgery for gastrointestinal stromal tumor presented with abdominal pain, weakness, weight loss, and vomiting. An examination revealed a chronically sick looking, emaciated patient with a long midline abdominal scar, and tenderness on deep palpation all over the abdomen. Ultrasound revealed diffuse intra-abdominal masses and a big liver mass. On laparotomy, innumerable masses were found to arise from the outer walls of whole small intestine and mesentery, and there was a soft, 8×10 cm size liver mass. Histology showed highly cellular interlacing bundles of proliferating smooth muscle cells not associated with nuclear atypia or mitotic figures, and there was no necrosis seen, suggesting cellular leiomyoma. CONCLUSION: Leiomyomatosis peritonealis disseminata is a very rare condition, especially in men and postmenopausal women. It should be considered as a differential in patients with disseminated intra-abdominal masses arising in mesentery, peritoneum, and on walls of the intestine.