title: Disseminated peritoneal leiomyomatosis postmorcellated resection of uterine leiomyomatous tissue.
abstract: In a retrospective review, we identified six cases of disseminated peritoneal leiomyomatosis (DPL) that occurred after resection for uterine leiomyoma(ta) using a morcellation procedure between 2010 and 2016. DPL occurred in less than 1% of all patients who underwent a prior hysterectomy with morcellation, and DPL never occurred without having underwent such a resection. The median age of women at the time of their original resection of uterine tissue was 38.6 years; the median time interval until resection of DPL after the primary morcellation procedure was 73 months and the median age was 48 years. At the time of DPL resection, a median of 6.5 individual lesions was present per patient, with each lesion having a median size of 1.2 cm in the greatest dimension. The most common peritoneal sites of involvement included the sigmoid colon serosa, right pelvis/pelvic side wall, and anterior abdominal parietal peritoneum. The same parameters are described for previously reported cases of DPL in the literature developing after a morcellated resection of uterine leiomyoma(ta). The use of morcellating hysterectomy specimens with leiomyomata may lead to the development of DPL by seeding, may involve numerous peritoneal sites, and often presents 2 years after the original resection.
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Sekulic
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Moench
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA.|Department of Pathology, Abbott Northwestern Hospital, Minneapolis, MN, USA.
authors.forename: Saeid
authors.initials: S
authors.lastname: Movahedi-Lankarani
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D018231:Leiomyomatosis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D000069577:Morcellation / Q000009:adverse effects*; D010534:Peritoneal Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies
keywords: Disseminated peritoneal leiomyomatosis; morcellator; smooth muscle neoplasm; uterine leiomyoma