Leiomyomatosis peritonealis disseminate with formation of endometrial cysts within tumors arising after supracervical laparoscopic hysterectomy

Abstract

Background: Use of morcellation during laparoscopic hysterectomy may result in seeding of uterine tissue throughout the abdominal cavity and development of ‘iatrogenic’ leiomyomatosis peritonealis disseminata. Case: Two years after a supracervical laparoscopic hysterectomy a 42-year-old parous women presented with abdominal pain and bloating. CT scans and subsequent surgical exploration reveled multiple solid tumors containing cysts filled with altered blood. Histologically, the tumors had characteristic features of a benign leiomyoma with smooth muscle cells infiltrated by endometrial glands. Conclusion: Pieces of smooth muscle cell and endometrial uterine tissue lost in the abdominal cavity during morcellation may progress to leiomyomatosis peritonealis disseminata with unusual appearance.