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Peer-reviewedCC BY-NC 3.0International Journal of Fertility & Sterility

Treatment Approach to Disseminated Peritoneal Leiomyomatosis in A Patient Desiring Future Fertility: A Case Report

  • Samantha E Neal1
  • Hannah T Ryles2
  • Christabel Koomson3
  • Obianuju Sandra Makueke-Laveaux2
  • Laura Douglass2
  1. 1Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois, USA
  2. 2Division of Minimally Invasive Surgery, Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois, USA
  3. 3Department of Obstetrics and Gynecology, University of Illinois Chicago, Chicago, Illinois, USA
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Abstract

Disseminated peritoneal leiomyomatosis (DPL) is a rare condition in which fibroids diffusely grow in extrauterine locations. Given its low prevalence, the literature is limited, making evidence-based treatment particularly challenging, especially in premenopausal patients. This case report describes a 34-year-old nulligravid woman with a history of two prior myomectomies who presented with upper abdominal bulk symptoms. Abdominal and pelvic magnetic resonance imaging (MRI) revealed multiple mesenteric and omental masses concerning for recurrent DPL. She underwent exploratory laparotomy with removal of 13 abdominal fibroids ranging from 2 to 12 cm. Postoperatively, her symptoms improved, and she was treated with a gonadotropin-releasing hormone (GnRH) analog (relugolix/estradiol/ norethindrone acetate) with a favorable response and sustained remission on follow up. Our case report demonstrates the efficacy of a novel medical therapy and our scoping review highlights the importance of aggressive surgical management followed by medical therapy for the treatment of DPL in patients with future fertility desires.

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Cite

BibTeXRIS
BibTeX
@article{neal2026treatment,
  title = {{Treatment Approach to Disseminated Peritoneal Leiomyomatosis in A Patient Desiring Future Fertility: A Case Report}},
  author = {Samantha E Neal and Hannah T Ryles and Christabel Koomson and Obianuju Sandra Makueke-Laveaux and Laura Douglass},
  journal = {International Journal of Fertility \& Sterility},
  year = {2026},
  month = oct,
  doi = {10.22074/ijfs.2026.2069660.1938},
  url = {https://doi.org/10.22074/ijfs.2026.2069660.1938},
  note = {CC BY-NC 3.0},
}
RIS
TY  - JOUR
TI  - Treatment Approach to Disseminated Peritoneal Leiomyomatosis in A Patient Desiring Future Fertility: A Case Report
AU  - Samantha E Neal
AU  - Hannah T Ryles
AU  - Christabel Koomson
AU  - Obianuju Sandra Makueke-Laveaux
AU  - Laura Douglass
PY  - 2026
DA  - 2026/10/03
JO  - International Journal of Fertility & Sterility
DO  - 10.22074/ijfs.2026.2069660.1938
UR  - https://doi.org/10.22074/ijfs.2026.2069660.1938
AB  - Disseminated peritoneal leiomyomatosis (DPL) is a rare condition in which fibroids diffusely grow in extrauterine locations. Given its low prevalence, the literature is limited, making evidence-based treatment particularly challenging, especially in premenopausal patients. This case report describes a 34-year-old nulligravid woman with a history of two prior myomectomies who presented with upper abdominal bulk symptoms. Abdominal and pelvic magnetic resonance imaging (MRI) revealed multiple mesenteric and omental masses concerning for recurrent DPL. She underwent exploratory laparotomy with removal of 13 abdominal fibroids ranging from 2 to 12 cm. Postoperatively, her symptoms improved, and she was treated with a gonadotropin-releasing hormone (GnRH) analog (relugolix/estradiol/ norethindrone acetate) with a favorable response and sustained remission on follow up. Our case report demonstrates the efficacy of a novel medical therapy and our scoping review highlights the importance of aggressive surgical management followed by medical therapy for the treatment of DPL in patients with future fertility desires.
SN  - 2008-076X
SN  - 2008-0778
ER  -