Disseminated Peritoneal Leiomyomatosis Mimicking Pelvic Malignancy: A Case Report
Abstract
Disseminated peritoneal leiomyomatosis (DPL) is a rare benign condition characterized by multiple smooth muscle nodules throughout the peritoneum. We report a 36-year-old woman presenting with vaginal bleeding and a large pelvic mass. Preoperative MRI raised concern for malignancy, including leiomyosarcoma. Surgical
and histopathological evaluation, however, revealed a benign uterine leiomyoma, an ovarian fibroma, and multiple omental smooth muscle nodules consistent with DPL. Notably, the patient had no history of prior uterine morcellation. This case underscores the importance of histopathological and immunohistochemical confirmation to differentiate DPL from malignant processes, preventing overtreatment and guiding
appropriate management.
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[2] Soni S, Pareek P, Narayan S. Disseminated peritoneal leiomyomatosis: an unusual presentation of intra-abdominal lesion mimicking disseminated malignancy. Med Pharm Rep. 2020;93:113. https://doi.org/10.15386/mpr-1421
[3] Liu X, Hu Y, Chen L, Zhou Q. Disseminated peritoneal leiomyomatosis: a case report and review of the literature. J
Int Med Res. 2021;49:03000605211033194. https://doi.org/10.1177/03000605211033194
[4] Li J, Dai S. Leiomyomatosis peritonealis disseminata: a clinical analysis of 13 cases and literature review. Int J Surg Pathol. 2020;28:163-8. https://doi.org/10.1177/1066896919880962
[5] Ordulu Z, Cin PD, Chong WW, Choy KW, Lee C, Muto MG, et al. Disseminated peritoneal leiomyomatosis after laparoscopic supracervical hysterectomy with characteristic molecular cytogenetic findings of uterine leiomyoma. Genes Chromosomes Cancer. 2010;49:1152-60. https://doi.org/10.1002/gcc.20824
[6] Ma Y, Wang S, Liu Q, Lu B. A clinicopathological and molecular analysis in uterine leiomyomas and concurrent/metachronous peritoneal nodules: new insights into disseminated peritoneal leiomyomatosis. Pathol Res Pract. 2020;216:152938. https://doi.org/10.1016/j.prp.2020.152938
[7] Xu X, Liu N, Liu S, Fang X, Chen H. Advances in the understanding and management of leiomyomatosis peritonealis disseminata: a narrative review. Int J Gynaecol Obstet. 2025;170:1014-23. https://doi.org/10.1002/ijgo.70154
[8] Yang R, Xu T, Fu Y, Cui S, Yang S, Cui M. Leiomyomatosis peritonealis disseminata associated with endometriosis: a case report and review of the literature. Oncol Lett. 2015;9:717-20. https://doi.org/10.3892/ol.2014.2741
[9] Bisi R, Carnevale A, Feliciani G, Giganti M, Palo AC. Disseminated peritoneal leiomyomatosis: description of a case, radiologic semiotics and differential diagnosis. Ann Ital Chir. 2025;96:451- 64. https://doi.org/10.62713/aic.3751
[10] He X, Ma X, Jiang N, Weng C, Yang L. Computed tomography and magnetic resonance imaging features of abdominal and pelvic leiomyomatosis peritonealis disseminata: a retrospective observational study. J Clin Imaging Sci. 2025;15:6. https://doi.org/10.25259/JCIS_144_2024
[11] Barnaś E, Książek M, Raś R, Skręt A, Skręt-Magierło J, Dmoch-Gajzlerska E. Benign metastasizing leiomyoma: a review of current literature in respect to the time and type of previous gynecological surgery. PLoS One. 2017;12:e0175875. https://doi.org/10.1371/journal.pone.0175875
[12] Momtahan M, Nemati M, Safaei A. Disseminated peritoneal leiomyomatosis. Iran J Med Sci. 2011;36:57.
[13] Gerashchenko AV, Filonenko TG, Golubinskaya EP, Kalfa MA,Kriventsov MA. Morcellation-induced leiomyomatosis peritonealis disseminata: a rare case report. Iran J Med Sci.2019;44:60.
[14] Moghadamfalahi M, Metzinger DS. Multiple extrauterine adenomyomas presenting in upper abdomen and pelvis: a case report and brief review of the literature. Case Rep Obstet Gynecol. 2012;2012:565901. https://doi.org/10.1155/2012/565901
[2] Soni S, Pareek P, Narayan S. Disseminated peritoneal leiomyomatosis: an unusual presentation of intra-abdominal lesion mimicking disseminated malignancy. Med Pharm Rep. 2020;93:113. https://doi.org/10.15386/mpr-1421
[3] Liu X, Hu Y, Chen L, Zhou Q. Disseminated peritoneal leiomyomatosis: a case report and review of the literature. J
Int Med Res. 2021;49:03000605211033194. https://doi.org/10.1177/03000605211033194
[4] Li J, Dai S. Leiomyomatosis peritonealis disseminata: a clinical analysis of 13 cases and literature review. Int J Surg Pathol. 2020;28:163-8. https://doi.org/10.1177/1066896919880962
[5] Ordulu Z, Cin PD, Chong WW, Choy KW, Lee C, Muto MG, et al. Disseminated peritoneal leiomyomatosis after laparoscopic supracervical hysterectomy with characteristic molecular cytogenetic findings of uterine leiomyoma. Genes Chromosomes Cancer. 2010;49:1152-60. https://doi.org/10.1002/gcc.20824
[6] Ma Y, Wang S, Liu Q, Lu B. A clinicopathological and molecular analysis in uterine leiomyomas and concurrent/metachronous peritoneal nodules: new insights into disseminated peritoneal leiomyomatosis. Pathol Res Pract. 2020;216:152938. https://doi.org/10.1016/j.prp.2020.152938
[7] Xu X, Liu N, Liu S, Fang X, Chen H. Advances in the understanding and management of leiomyomatosis peritonealis disseminata: a narrative review. Int J Gynaecol Obstet. 2025;170:1014-23. https://doi.org/10.1002/ijgo.70154
[8] Yang R, Xu T, Fu Y, Cui S, Yang S, Cui M. Leiomyomatosis peritonealis disseminata associated with endometriosis: a case report and review of the literature. Oncol Lett. 2015;9:717-20. https://doi.org/10.3892/ol.2014.2741
[9] Bisi R, Carnevale A, Feliciani G, Giganti M, Palo AC. Disseminated peritoneal leiomyomatosis: description of a case, radiologic semiotics and differential diagnosis. Ann Ital Chir. 2025;96:451- 64. https://doi.org/10.62713/aic.3751
[10] He X, Ma X, Jiang N, Weng C, Yang L. Computed tomography and magnetic resonance imaging features of abdominal and pelvic leiomyomatosis peritonealis disseminata: a retrospective observational study. J Clin Imaging Sci. 2025;15:6. https://doi.org/10.25259/JCIS_144_2024
[11] Barnaś E, Książek M, Raś R, Skręt A, Skręt-Magierło J, Dmoch-Gajzlerska E. Benign metastasizing leiomyoma: a review of current literature in respect to the time and type of previous gynecological surgery. PLoS One. 2017;12:e0175875. https://doi.org/10.1371/journal.pone.0175875
[12] Momtahan M, Nemati M, Safaei A. Disseminated peritoneal leiomyomatosis. Iran J Med Sci. 2011;36:57.
[13] Gerashchenko AV, Filonenko TG, Golubinskaya EP, Kalfa MA,Kriventsov MA. Morcellation-induced leiomyomatosis peritonealis disseminata: a rare case report. Iran J Med Sci.2019;44:60.
[14] Moghadamfalahi M, Metzinger DS. Multiple extrauterine adenomyomas presenting in upper abdomen and pelvis: a case report and brief review of the literature. Case Rep Obstet Gynecol. 2012;2012:565901. https://doi.org/10.1155/2012/565901
| Files | ||
| Issue | Vol 11 No 3 (2026): May-June | |
| Section | Case Report(s) | |
| Keywords | ||
| Disseminated peritoneal leiomyomatosis Leiomyoma Pelvic mass Leiomyosarcoma Ovarian fibrothectoma Peritoneal nodules | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Zafarbakhsh A, Naeimi A, Hosseini N. Disseminated Peritoneal Leiomyomatosis Mimicking Pelvic Malignancy: A Case Report. CRCP. 2026;11(3):143-148.
