Long‐term efficacy and safety of aromatase inhibitor use for leiomyomatosis peritonealis disseminata

Hitomi Ando, Soshi Kusunoki, Tsuyoshi Ota, Yayoi Sugimori, Shozo Matsuoka, Daiki Ogishima
In: Journal of Obstetrics and Gynaecology Research · 2017 · vol. 43(9) , pp. 1489–1492 · doi:10.1111/jog.13376 · PMID:28691239 · W2735091264
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Aromatase inhibitor therapy with letrozole demonstrated long-term efficacy and safety in a patient with recurrent leiomyomatosis peritonealis disseminata after bilateral salpingo-oophorectomy.

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Abstract

Leiomyomatosis peritonealis disseminata is a rare disease characterized by pelvic smooth-muscle nodules of various sizes. It is sometimes misdiagnosed as ovarian or peritoneal carcinoma metastasis; therefore, surgical excision for pathological diagnosis is required. Treatment options include bilateral salpingo-oophorectomy (BSO), gonadotrophin-releasing hormone agonist therapy, and aromatase inhibitor therapy. All of these suppress estrogen levels, but a standard treatment has not been established. A 40-year-old woman had multiple pelvic tumors, suspicious for ovarian cancer. She underwent laparotomy, where frozen sections of the nodules revealed leiomyomatosis peritonealis disseminata. After she completed gonadotrophin-releasing hormone agonist therapy, we performed a total abdominal hysterectomy and BSO with residual-nodule resection, but the nodules recurred 6 months after surgery. We then started letrozole, and 3 years have now elapsed without nodule enlargement or development of new lesions. The long-term use of aromatase inhibitor therapy is thought to be effective and safe for patients with recurrence after BSO.

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