PDF(Pubmed)
Abstract：
UNASSIGNED: Leiomyomatosis peritonealis disseminata (LPD) is a non-metastatic, homologous, multicentric benign disorder characterized by small leiomyomas scattered over the peritoneum and omentum. It is a rare and benign disease with invasive potential. LPD mainly attacks women of childbearing age but has also been reported in post-menopausal women, men, and young children. Non-specific clinical and imaging findings of LPD lead to difficult diagnoses and treatment.
UNASSIGNED: This study reports the case of a patient with recurrent LPD with endometriosis after multiple myomectomies and hysterectomy, who presented recurrent abdominal pain with progressive exacerbation. Imaging examinations showed irregular shadows in the pelvic cavity and multiple nodular changes in the peritoneum, which were considered malignant lesions. A solid mass sized 10 cm × 9 cm × 10 cm in the inferior pelvis and nodules scattered over the surface of pelvic and abdominal organs and the peritoneum were detected during the surgery. The patient was treated with cytoreductive surgery (CRS), peritonectomy, ovarian ablation, and hyperthermic intraperitoneal chemotherapy (HIPEC). The surgery was challenging, and the intraoperative bleeding reached 900 ml. However, the patient recovered well and achieved a tumor-free survival of 13 months.
UNASSIGNED: It was concluded that a combination of CRS, ovarectomy, and HIPEC might be one of the therapeutic strategies for recurrent LPD.
UNASSIGNED: This study reports the case of a patient with recurrent LPD with endometriosis after multiple myomectomies and hysterectomy, who presented recurrent abdominal pain with progressive exacerbation. Imaging examinations showed irregular shadows in the pelvic cavity and multiple nodular changes in the peritoneum, which were considered malignant lesions. A solid mass sized 10 cm × 9 cm × 10 cm in the inferior pelvis and nodules scattered over the surface of pelvic and abdominal organs and the peritoneum were detected during the surgery. The patient was treated with cytoreductive surgery (CRS), peritonectomy, ovarian ablation, and hyperthermic intraperitoneal chemotherapy (HIPEC). The surgery was challenging, and the intraoperative bleeding reached 900 ml. However, the patient recovered well and achieved a tumor-free survival of 13 months.
UNASSIGNED: It was concluded that a combination of CRS, ovarectomy, and HIPEC might be one of the therapeutic strategies for recurrent LPD.
摘要：
■腹膜播散平滑肌瘤病（LPD）是非转移性的，同源,多中心良性疾病，其特征是散布在腹膜和网膜上的小平滑肌瘤。这是一种罕见的良性疾病，具有侵袭潜力。LPD主要袭击育龄妇女，但在绝经后妇女中也有报道，男人,和年幼的孩子。LPD的非特异性临床和影像学表现导致诊断和治疗困难。
■本研究报告了1例子宫内膜异位症患者在多次子宫切除术和子宫切除术后复发的子宫内膜异位症，表现为复发性腹痛并进行性加重。影像学检查显示盆腔有不规则阴影,腹膜内多发结节状改变,被认为是恶性病变。术中发现下骨盆有10cm×9cm×10cm的实体肿块，结节散布在骨盆和腹部器官表面以及腹膜上。患者接受了细胞减灭术（CRS）治疗，围手术期,卵巢消融,和腹腔热化疗（HIPEC）。手术很有挑战性,术中出血量达到900ml。然而,患者恢复良好,无瘤生存期为13个月.
■得出的结论是，CRS的组合，卵巢切除术,HIPEC可能是复发性LPD的治疗策略之一。
■本研究报告了1例子宫内膜异位症患者在多次子宫切除术和子宫切除术后复发的子宫内膜异位症，表现为复发性腹痛并进行性加重。影像学检查显示盆腔有不规则阴影,腹膜内多发结节状改变,被认为是恶性病变。术中发现下骨盆有10cm×9cm×10cm的实体肿块，结节散布在骨盆和腹部器官表面以及腹膜上。患者接受了细胞减灭术（CRS）治疗，围手术期,卵巢消融,和腹腔热化疗（HIPEC）。手术很有挑战性,术中出血量达到900ml。然而,患者恢复良好,无瘤生存期为13个月.
■得出的结论是，CRS的组合，卵巢切除术,HIPEC可能是复发性LPD的治疗策略之一。
