Diffuse leiomyomatosis uterus, rare case report with review of literature

ABSTRACT: Diffuse uterine leiomyomatosis (DLM), a rare benign myometrial disorder marked by uniform, diffuse proliferation of smooth muscle nodules throughout the uterus. Its clinical and imaging features often resemble multiple discrete uterine leiomyomas, leading to frequent preoperative misdiagnosis.1 We present a case of 48 year old postmenopausal female( Para 2, living 2 ) with diffuse uterine leiomyomatosis (DLM). She presented with abnormal uterine bleeding. Ultrasound showed bulky uterus with large uterine fibroids. Magnetic resonance imaging (MRI) of the whole abdomen revealed an enlarged uterus with large intramural fibroid of size 10.7 × 8.7 × 8.5 cm in the right side fundus region and body of uterus displacing the endometrium towards left side along with numerous coalescing fibroids in rest of the myometrium. Total abdominal hysterectomy was performed. The specimen showed multiple coalescent nodules occupying almost entire myometrium .Multiple sections confirmed coalescent leiomyomata with merging boundaries with focal areas of hydropic change and myxoid degeneration. A diagnosis of diffuse uterine leiomyomatosis was signed out. This case is being presented for its rarity. Keywords: DLM (diffuse uterine leiomyomatosis), myometrium, total abdominal hysterectomy, MRI