Disseminated Peritoneal Leiomyomatosis Mimicking Pelvic Malignancy: A Case Report

Abstract

Disseminated peritoneal leiomyomatosis (DPL) is a rare benign condition characterized by multiple smooth muscle nodules throughout the peritoneum. We report a 36-year-old woman presenting with vaginal bleeding and a large pelvic mass. Preoperative MRI raised concern for malignancy, including leiomyosarcoma. Surgical and histopathological evaluation, however, revealed a benign uterine leiomyoma, an ovarian fibroma, and multiple omental smooth muscle nodules consistent with DPL. Notably, the patient had no history of prior uterine morcellation. This case underscores the importance of histopathological and immunohistochemical confirmation to differentiate DPL from malignant processes, preventing overtreatment and guiding appropriate management.