2022 年 38 巻 2 号 p. 75-81
Parasitic peritoneal leiomyomatosis (PL) and disseminated peritoneal leiomyomatosis (DPL) are rare medical conditions; however, cases have been widely reported in recent years. Case1: A 43-year-old woman presented at our hospital, eight years after a laparoscopic myomectomy, with anemia and a uterine tumor. Magnetic resonance imaging and computed tomography (CT) scans revealed a uterine mass, several other pelvic masses, and a subcutaneous mass in the umbilicus. Endometrial stromal sarcoma was suspected, and she underwent an open laparotomy to remove the masses. The pelvic tumors were found attached to the vesicouterine peritoneum. Upon rapid intraoperative pathological examination, the tumor appeared benign. She underwent total hysterectomy and tumor resection surgery. Histopathologic examination revealed that the masses were Estrogen Receptor- and Progesterone Receptors-positive leiomyomas. Case2: A 46-year-old woman presented at our hospital, about seven years after a total laparoscopic supracervical hysterectomy, with stomach pain. CT scans revealed a sigmoid colon mass. She underwent a laparoscopic tumor resection surgery. Histopathologic examination revealed that the mass was a leiomyoma. Efforts should be taken to prevent iatrogenic leiomyomas dissemination; whenever possible, tumor morcellation should be done in a containment bag. Considering each patient's history of gynecologic surgery, we believe these were rare cases of DPL following laparoscopic uterine myomectomy.