Leiomyomatosis Peritonealis Disseminata Pathophysiology and Management

Leiomyomatosis peritonealis disseminata (LPD) is a rare condition characterised by multiple benign smooth muscle nodules distributed across the peritoneal and omental surfaces. Although typically non-metastatic, LPD can mimic malignant peritoneal disease and, in rare instances, undergo sarcomatous transformation. Hormonal influences, particularly oestrogen and progesterone, are implicated in lesion growth, while iatrogenic factors such as uncontained tissue morcellation during laparoscopic myomectomy contribute to dissemination. Presentation ranges from incidental findings to nonspecific abdominal pain or mass effect. Diagnostic evaluation integrates ultrasound, computed tomography and magnetic resonance imaging, with definitive diagnosis achieved by histopathology and immunohistochemistry. Management is tailored to symptom burden and disease extent. Surgical excision remains the cornerstone for symptomatic or progressive lesions, with strategies encompassing cytoreductive surgery and, in selected recurrent cases, intraperitoneal chemotherapy. Hormonal suppression through gonadotrophin-releasing hormone agonists, aromatase inhibitors or selective progesterone receptor modulators offers a conservative alternative for small or asymptomatic nodules. Emerging molecular insights and multidisciplinary approaches aim to refine personalised treatment and reduce iatrogenic risk.

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Leiomyomatosis Peritonealis Disseminata Pathophysiology and Management publication trend

The graph below shows the total number of articles in leiomyomatosis peritonealis disseminata pathophysiology and management across all publications each year (not limited to Nature Index journals).

Technical terms

Leiomyomatosis peritonealis disseminata: A rare disorder where multiple benign smooth muscle tumours form on peritoneal surfaces.

Leiomyoma: A benign smooth muscle tumour, often of uterine origin, that gives rise to peritoneal nodules in LPD.

Iatrogenic dissemination: Spread of tissue fragments during surgical procedures, notably uncontained morcellation.

Cytoreductive surgery: Surgical removal of as much tumour burden as possible to improve outcomes.

Hyperthermic intraperitoneal chemotherapy (HIPEC): Circulation of heated chemotherapeutic agents within the abdominal cavity to eradicate residual tumour cells.

Gonadotrophin-releasing hormone agonist: A class of drugs that suppress ovarian hormone production to inhibit tumour growth.

Aromatase inhibitor: Medication that blocks conversion of androgens to oestrogens, reducing hormonal stimulation of tumours.

Morcellation: Surgical technique that fragments tissue, which may inadvertently disperse tumour cells.

References

1. Combination therapy of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for recurrent leiomyomatosis peritonealis disseminata with endometriosis: A case report. Heliyon (2023).
2. Disseminated Peritoneal Leiomyomatosis—A Challenging Diagnosis-Mimicking Malignancy Scoping Review of the Last 14 Years. Biomedicines (2024).
3. Effect of medical treatments in disseminated peritoneal leiomyomatosis: a case report. Journal of Surgical Case Reports (2022).