A Case of Disseminated Peritoneal Leiomyomatosis Developing after Laparoscope-Assisted Myomectomy

Vol. 67, No. 2, 2009

Free Abstract Article (References) Article (PDF 284 KB)

Case Report

A Case of Disseminated Peritoneal Leiomyomatosis Developing after Laparoscope-Assisted Myomectomy
Takahito Miyake^a, Takayuki Enomoto^a, Yutaka Ueda^a, Kenichiro Ikuma^b, Eiichi Morii^c, Shinya Matsuzaki^a, Yuji Murata^a

^aDepartment of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita;
^bDepartment of Obstetrics and Gynecology, Takarazuka City Hospital, Takarazuka, and
^cDepartment of Pathology, Osaka University Graduate School of Medicine, Suita, Japan

Address of Corresponding Author

Gynecol Obstet Invest 2009;67:96-102 (DOI: 10.1159/000164949)

Key Words

Disseminated peritoneal leiomyomatosis
Laparoscopic myomectomy
Morcellation
Clonality
Androgen receptor
Methylation-specific polymerase chain reaction
Loss of heterozygosity

Abstract

A 36-year-old nulliparous woman developed multiple extra-uterine fibroids in the pelvic cavity years after laparoscopic myomectomy. Molecular genetic analysis by methylation-specific polymerase chain reaction (MSPCR) of the human X-linked androgen receptor gene and loss of heterozygosity (LOH) analysis at 5 microsatellite loci was performed on the tumors. All tumors showed an identical non-random X-chromosome inactivation pattern by MSPCR and an identical pattern of LOH was found in all the tumors by LOH analysis. This demonstrated that 3 fibroids resected 2 years later and 14 fibroids resected 6 years later were all metastatic tumors originating from the uterine leiomyoma found during the initial surgery, suggesting that morcellation before removal of the leiomyoma nodule during laparoscopic myomectomy may have been associated with the pathogenesis of this case.

Author Contacts

Dr. Takayuki Enomoto
Department of Obstetrics and Gynecology
Osaka University Graduate School of Medicine
2-2, Yamadaoka, Suita, Osaka 565-0871 (Japan)
Tel. +81 66879 3355, Fax +81 66879 3359, E-Mail enomoto@gyne.med.osaka-u.ac.jp

Article Information

Received: November 12, 2007
Accepted after revision: July 22, 2008
Published online: October 23, 2008
Number of Print Pages : 7
Number of Figures : 2, Number of Tables : 2, Number of References : 17

Medline Abstract (ID 18946223)

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