Disseminated peritoneal leiomyomatosis developing after laparoscopic conversion to open Myomectomy

Abstract

Background: The rising prevalence of laparoscopic gynecologic surgery brings with it a greater incidence of unusual sequelae, which were previously unrecognized or rarely encountered by clinicians. Case: A 43-year-old parous woman presented 3 years following a laparoscopic operation that had been converted to an open myomectomy. At her current presentation, she had signs and ultrasound images suggestive of recurrent uterine fibroid neoplasms. At laparotomy, she was found to have a normal uterus with many leiomyomas attached, instead, to her pelvic peritoneum and omentum. Results: The patient had an uneventful recovery with no recurrences at her 1-year follow-up. Conclusions: Disseminated peritoneal leiomyomatosis is rare, especially after conversion from laparoscopic surgery to open myomectomy or hysterectomy. This case highlights the need for due surgical diligence to remove all morcellated fragments of myomas, as well as the importance for a raised awareness of such potential sequelae even years postoperatively. (J GYNECOL SURG 30:47) © Copyright 2014, Mary Ann Liebert, Inc. 2014.