Leiomyomatosis Peritonealis Disseminata - Repeat Abdominal Myomectomy With Hormonal Therapy: A Case Report From South-West Nigeria

Abstract Introduction Leiomyomatosis peritonealis disseminata (LPD) is a rare, typically benign condition characterized by multiple smooth muscle nodules proliferating along visceral and parietal peritoneal and abdominopelvic surfaces. Just a little over 200 cases have been reported worldwide since the condition was first described in 1952. This case highlights the possibility of finding LPD following previous abdominal myomectomy. Case presentation A 41-year old nullipara with recurrent fibroid with menorrhagia, presented to the gynaecology clinic with huge abdominal mass, for repeat abdominal myomectomy. Preoperative assessment was done with physical examination and investigations. Following abdominal myomectomy, incidental appendectomy and random excision biopsy of widespread tiny nodules on the gut mesentry and mesoappendix; histopathological assessment revealed disseminated leiomyoma nodules with an isolated focus of endometriosis. Conclusion LPD is a distant rarity, however, a high index of suspicion is required when a woman with risk factors for the condition is having myomectomy (especially a repeat myomectomy). The excision biopsy of peritoneal nodules should be subjected to histopathologic assessment to clinch the diagnosis of LPD.