Diffuse peritoneal leiomyomatosis
Diffuse/disseminated peritoneal leiomyomatosis (DPL), also known as leiomyomatosis peritonealis disseminata, is an exceedingly rare benign disorder characterised by multiple vascular leiomyomas growing along the submesothelial tissues of the abdominopelvic peritoneum.
DPL is usually discovered incidentally in women of reproductive age.
- long-term use of oral contraceptives
- granulosa cell tumours of the ovary 1
- pregnancy 5
A spectrum of features can be seen ranging from multiple solid subcentimetre nodules like those in peritoneal carcinomatosis to large solid masses on both ultrasound and CT. These masses may show homogeneous or heterogeneous attenuation with a variable enhancement pattern similar to that of uterine leiomyomas.
May show multiple masses with signal intensity similar to that of skeletal muscle and smooth muscle on both T1WI and T2WI. Homogeneous enhancement following the administration of contrast material.
History and etymology
The condition was first defined by H D Taubert et al in 1965 3.
General considerations include:
- peritoneal carcinomatosis: typically patients have associated weight loss, ascites, and disease progression observed at imaging
- 1. Fasih N, Prasad shanbhogue AK, Macdonald DB et-al. Leiomyomas beyond the uterus: unusual locations, rare manifestations. Radiographics. 28 (7): 1931-48. doi:10.1148/rg.287085095 - Pubmed citation
- 2. Rosica G, Santilli G, Bucari D et-al. A case of disseminated peritoneal leiomyomatosis and diffuse uterine leiomyomatosis. Clin Exp Obstet Gynecol. 2011;38 (1): 84-7. - Pubmed citation
- 3. Taubert HD, Wissner SE, Haskins AL. Leimyomatosis peritonealis disseminata; An unusual complication of genital leimyomata. Obstet Gynecol. 1965;25 : 561-74. - Pubmed citation
- 4. Kökçü A, Alvur Y, Bariş YS et-al. Leiomyomatosis peritonealis disseminata. Acta Obstet Gynecol Scand. 1994;73 (1): 81-3. - Pubmed citation
- 5. Clement PB, Young RH. Atlas of Gynecologic Surgical Pathology: Expert Consult: Online (Atlases in Diagnostic Surgical Pathology). Saunders. ISBN:B00GC3C45I. Read it at Google Books - Find it at Amazon