# Leiomyomatosis Peritonealis Disseminata during successful pregnancy: First report in Africa

## TL;DR

This paper reports the first case of a rare benign tumor condition in a pregnant woman in Africa, highlighting its diagnostic challenges and successful treatment.

## Contribution

The first documented case of Leiomyomatosis Peritonealis Disseminata in Africa and during pregnancy, offering insights into its management.

## Key findings

- Leiomyomatosis Peritonealis Disseminata was confirmed through histopathological and immuno-histochemical analysis.
- The case was successfully managed with conservative treatment, avoiding aggressive interventions.
- The condition was linked to hormonal influence due to its occurrence during pregnancy.

## Abstract

Leiomyomatosis peritonealis disseminata is a very rare disease that involves the presence of multiple benign tumors of smooth muscle origin all over the peritoneal cavity. Due to its ability to mimic malignant pathologies, it is associated with significant diagnostic and therapeutic challenges. This case highlights a unique case of LPD to further raise awareness and provide useful information on how to manage this condition.

A 28-year-old female was admitted with progressive increase in abdominal distension and discomfort. Imaging studies revealed multiple peritoneal nodules that mimicked metastatic disease. Laparoscopic exploration and histopathological examination subsequently confirmed the diagnosis of LPD. She never had a history of malignancy and hormonal therapy, which are the usual associations with this condition.

Diagnosis of LPD is usually missed because its clinically and radiologically smoky appearance of the belly may mimic peritoneal carcinomatosis. Pathogenesis includes hormonal factors, though rare cases are idiopathic. Symptomatic nodules are usually treated with surgical excision and in recurrent cases, attempts at hormonal manipulation can be done.

This case shows the inclusion of LPD in the differential diagnosis of peritoneal masses is of paramount importance, especially in women of childbearing age. Early and accurate diagnosis will help in avoiding the unnecessary aggressive measures.

•First reported case of Leiomyomatosis Peritonealis Disseminata from Libya and Africa, with its international contribution to the literature.•A challenging diagnosis because of a malignancy-like presentation. Diagnosis, therefore, needs a confirming histopathological examination.•Histopathologic Diagnosis: Diagnosis confirmed through histopathologic and immuno-histochemical examination showed positive immuno-histochemical reaction for actin and desmin, in contrast to malignancy markers CD34, CD117, DOG1, S100, and β-catenin.•Successful conservative treatment with good outcomes; therefore, this case provides some hint about the strategies adopted for management. Rare incident to be reported in pregnancy; thus, it opens a scope toward hormonal influence.

First reported case of Leiomyomatosis Peritonealis Disseminata from Libya and Africa, with its international contribution to the literature.

A challenging diagnosis because of a malignancy-like presentation. Diagnosis, therefore, needs a confirming histopathological examination.

Histopathologic Diagnosis: Diagnosis confirmed through histopathologic and immuno-histochemical examination showed positive immuno-histochemical reaction for actin and desmin, in contrast to malignancy markers CD34, CD117, DOG1, S100, and β-catenin.

Successful conservative treatment with good outcomes; therefore, this case provides some hint about the strategies adopted for management. Rare incident to be reported in pregnancy; thus, it opens a scope toward hormonal influence.