Leiomyomatosis peritonealis disseminata complicated by sarcomatous transformation and ovarian torsion: presentation of two cases and review of the literature

Abstract

Leiomyomatosis peritonealis disseminata (LPD) is a rare disorder usually discovered incidentally in women of child-bearing age and is characterized by multiple subperitoneal smooth muscle nodules. Case reports of two patients with complications related to LPD and a review of the literature are presented. In one case, the patient carried the diagnosis of LPD for 11 years and experienced sarcomatous transformation; this is the first report of the magnetic resonance appearance of this entity. In the second case, LPD was diagnosed after an LPD implant on the ovary-induced ovarian torsion. We also present a patient in whom large, pedunculated uterine leiomyomas mimicked LPD. The clinical presentation, possible pathogenesis, imaging features, and therapeutic options of LPD are reviewed. Because this uncommon condition is being reported with increasing frequency, familiarity with its imaging features and pitfalls is important to suggest the diagnosis in the appropriate clinical setting.