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J. Clin. Med. 2018, 7(8), 207; https://doi.org/10.3390/jcm7080207

Epithelial-Mesenchymal Transition with Malignant Transformation Leading Multiple Metastasis from Disseminated Peritoneal Leiomyomatosis

1
Department of Obstetrics and Gynecology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei 231, Taiwan
2
Department of Obstetrics and Gynecology, School of Medicine, Tzu Chi University, Hualien 970, Taiwan
3
Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei 231, Taiwan
4
Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien 970, Taiwan
5
Department of Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei 231, Taiwan
6
Department of Radiation Oncology, Show Chwan Memorial Hospital, Changhua 500, Taiwan
7
Research Assistant Center, Show Chwan Memorial Hospital, Changhua 500, Taiwan
8
Department of Hematology and Oncology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei 231, Taiwan
These authors contributed equally to this work.
*
Authors to whom correspondence should be addressed.
Received: 28 July 2018 / Revised: 3 August 2018 / Accepted: 6 August 2018 / Published: 9 August 2018
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Abstract

Disseminated peritoneal leiomyomatosis (DPL) is a rare condition that is characterized by the presence of multiple subperitoneal or peritoneal smooth muscle nodules of varying sizes on the omentum and peritoneal surfaces, grossly mimicking disseminated carcinoma. DPL usually develops in premenopausal women with a benign course, and it is often found incidentally during abdominal surgery. Malignant transformation is a rare clinical course of DPL. Only a few studies have focused on DPL transformation into a leiomyosarcoma. Herein, we describe the case of a 61-year-old woman with a history of recurrent leiomyoma of the uterus who presented with intermittent progressive abdominal pain. The imaging study revealed a huge heterogeneous density mass in the pelvic region with pulmonary and hepatic metastases. Exploratory laparotomy and debulking surgery were performed, and showed the coexistence of DPL and leiomyosarcoma. She died approximately one month after the diagnosis because of rapid progression of pleural effusion due to malignancy. This case highlights the clinical features of DPL and its malignant transformation and metastasis so physicians can make an early diagnosis and provide timely management. View Full-Text
Keywords: leiomyomatosis; peritonealis disseminata; leiomyosarcoma; sarcomatous transformation leiomyomatosis; peritonealis disseminata; leiomyosarcoma; sarcomatous transformation
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Chiu, H.-C.; Wu, M.-Y.; Li, C.-H.; Huang, S.-C.; Yiang, G.-T.; Yen, H.-S.; Liu, W.-L.; Li, C.-J.; Kao, W.-Y. Epithelial-Mesenchymal Transition with Malignant Transformation Leading Multiple Metastasis from Disseminated Peritoneal Leiomyomatosis. J. Clin. Med. 2018, 7, 207.

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