Re: Diffuse Peritoneal Leiomyomatosis-an interesting case

From: ENDODOK@aol.com
Fri Apr 27 13:18:05 2007


40 yr.old G2P2 underwent uneventful LSH for symptomatic 12 week singular fibroid, in 2002. Subsequently seen by another gyn, (Jan 2007) and found to have a 17cm pelvic mass. At laparotomy, gyn onc found large lobulated mass adherent to upper sigmoid. Also 2 mesenteric nodules Mass resected as well as 10cm of colon,BSO, & trachelectomy & omentectomy .Frozen section, possible low grade sarcoma. Final path= leiomyoma (histologically the same as original leiomyoma); endometriosis of small bowel mesentary, and omentum.

Tissue positive progesterone receptors,negative ER. Pt now on Megace This case was deemed highly unusual by Stanford consultants.

Moral of the story: If LSH, thorough removal of all tissue pieces after morcellation; copious irrigation to remove any residual detached endometrium. Anyone have any thoughts re incidence this bizarre post LSH occurence??

J. Glenn Bradley

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    40 yr.old G2P2 underwent uneventful LSH for symptomatic 12 week singular fibroid, in 2002. Subsequently seen by another gyn, (Jan 2007) and found to have a 17cm pelvic mass. At laparotomy, gyn onc found large lobulated mass adherent to upper sigmoid. Also 2 mesenteric nodules
    Mass resected as well as 10cm of colon,BSO, & trachelectomy & omentectomy .Frozen section, possible low grade sarcoma.
    Final path= leiomyoma (histologically the same as original leiomyoma); endometriosis of small bowel mesentary, and omentum.
 
    Tissue positive progesterone receptors,negative ER. Pt now on Megace
This case was deemed highly unusual by Stanford consultants.
 
Moral of the story: If LSH, thorough removal of all tissue pieces after morcellation;  copious irrigation to remove any residual detached endometrium. Anyone have any thoughts re incidence this bizarre post LSH occurence??
 
J. Glenn Bradley




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