When unexpected intraoperative peritoneal dissemination is encountered, disseminated peritoneal leiomyomatosis should be considered in the differential diagnosis alongside malignancy, recognizing that it can develop even in a patient without prior gynecologic treatment, which is extremely rare. Careful intra-abdominal assessment and appropriate surgical decision-making are essential. Given that only isolated reports have described disseminated peritoneal leiomyomatosis presenting with acute abdomen or torsion-related symptoms, the present case further underscores the exceptional rarity of this clinical scenario.
Watanabe et al. (Fri,) studied this question.