Leiomyomatosis Peritonealis Disseminate Following Laparoscopic Myomectomy with Power Morcellation

Background: Leiomyomatosis peritonealis disseminate (LPD) is a rare benign entity, but its histological origin remains unclear. Cases: An unusual DPL case which was diagnosed at 4 years after her initial laparoscopic uterine myomectomy with power morcellation, and recurred 4 years later. The findings during the exploratory laparotomy mimicked peritoneal carcinomatosis, which was characteristic of innumerous nodules throughout the peritoneal surface ranging from several millimeters to cenitimeters in diameters. She was treated with omentectomy and debulking of numerous large tumors. Gonadotropin releasing hormone analogue was given for 6 months after her initial laparotomy. Histopathological examination confirmed a consistent morphology of cellular leiomyoma in the uterine and LPD tumors. Conclusion: Our case suggested an emerging origin of LPD, iatrogenic implantation following laparoscopic procedures with power morcellation. Teaching points: LPD following laparoscopic myomectomy with power morcellation can mimic carcinomatosis clinically. Particular caution should be exerted on power morcellation when the leiomyoma had an unusual appearance.