Hidden past history Uterine myomectomy Surgical findings Omental mass 및 T-colon mesentery부근의 mass의 excision시행 Feeding vessel은 right colic artery에서 유래한 것으로 보임 Pathology report Leiomyoma
Mesenteric and omental lesions (In Gore textbook) Primary neoplasm Desmoid tumors Malignant peritoneal mesothelioma Primary peritoneal serous carcinoma Well-differentiated papillary mesothelioma Multicystic peritoneal mesothelioma Desmoplastic small round cell tumor Adenomatoid tumor Other primary mesenchymal tumors : hemangioma, hemangiopericytoma, lymphangioma, lipoma, liposarcoma, neurogenic tumor, leiomyomatosis peritonealis disseminata (LPD), sarcoma Secondary tumors Peritoneal carcinomatosis Carcinoid tumor Lymphoma
Benign uterine variants of leiomyoma with extra-uterine disease Primarily in reproductive age women Often respond to therapies that reduce serum estrogen concentration Pathobiological mechanism: remains to be determined Estrogen stimulation Peritoneal dissemination secondary to fibroid resection or hysterectomy Peritoneal metaplasia: sometimes developed in female with no uterine myoma Leiomyomatosis peritonealis disseminata (LPD), intravenous leiomyomatosis, benign metastasizing leiomyomas
Leiomyomatosis peritonealis disseminata or disseminated peritoneal leiomyomatosis Generally benign and asymptomatic a small number (probably <5 %) undergo malignant transformation Imaging CT: homogeneous enhancing masses in all over the peritoneal surfaces (esp. near the uterus) MRI: multiple well-defined peritoneal nodules T1 intermediate SI (similar to pelvic wall muscles), T2 low SI, homogeneous enhancement Malignant transformation: large peritoneal nodules with central necrosis, smooth outer margins, liver metastasis