A Case Of Disseminated Peritoneal Leiomyomatosis Developed Six Years After Laparoscope-Assisted Myomectomy

We experienced a case of DPL who had a past history of repetitive laparoscope-assisted myomectomy four years ad six years ago. We performed clonal analysis to examine whether disseminated peritoneal leiomyomatosis (DPL) arise from a single uterine smooth muscle cell and disseminated to the peritoneum or developed multifocally from the peritoneum. Clonal analysis was performed using methylation specific PCR (MSPCR) targetting exon 1 of the androgen receptor gene and loss of heterozygosity (LOH) analysis of five microsatellite. Clonal analysis showed similar pattern of X-chromosome inactivation and LOH in the uterine tumors previously resected and fourteen peritoneal tumors recently debalked. Suggesting that, all these tumors have same origin and arisen from a single cell. It is possible that the tumors removed in the past two operations and latest operation have the same origin. In this case, this DPL was observed after the laparoscope-assisted myomectomy performed several years before.