Leiomyomatosis peritonealis disseminata occurring in a postmenopausal woman: report of a case.

Leiomyomatosis peritonealis disseminata (LPD) is a rare condition, reported to occur chiefly in premenopausal women. In fact only five cases of LPD in postmenopausal women have been documented in the English literature. We report herein a case of LPD occurring in a postmenopausal woman who had undergone a total hysterectomy 15 years earlier and received no subsequent hormonal therapy. At laparotomy, a cystic mass measuring 10.0 x 12.0 cm was found adhering to the jejunum. There were also innumerable tumor nodules ranging from 0.5 to 5.0 cm in diameter attached to the antimesenteric borders of the intestine and the parietal peritoneum. We resected the cystic main tumor together with 20 cm of jejunum to release the intestinal obstruction. Several daughter tumors were also resected as biopsies for histological examination. Histologically, the lesions were multiple and consisted of proliferating smooth muscle cells with rod-like nuclei showing extremely rare mitotic figures, confirming a diagnosis of LPD.