IMR Press / EJGO / Volume 39 / Issue 5 / DOI: 10.12892/ejgo4120.2018
Open Access Case Report
Leiomyomatosis peritonealis disseminata with aromatase cytochrome P450 expression in a postmenopausal woman: a case study with literature review
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1 Hamamatsu University School of Medicine, Obstetrics and Gynaecology, Higashi-ku, Hamamatsu city, Shizuoka
2 Ito Municipal Hospital, Obstetrics and Gynaecology, Ito, Shizuoka, Japan
3 Ito Municipal Hospital, Pathology, Ito, Shizuoka, Japan
Eur. J. Gynaecol. Oncol. 2018 , 39(5), 838–842; https://doi.org/10.12892/ejgo4120.2018
Published: 10 October 2018
Abstract

Purpose of Investigation: The authors aimed to assess the hypothesis that leiomyomatosis peritonealis disseminata (LPD) in a postmenopausal woman had autocrine estrogen secretion abilities. Materials and Methods: A 73-year-old woman presented with a bulky tumour in the peritoneal cavity. The pathological diagnosis was LPD or sarcoma of unknown origin. Medroxyprogesterone acetate (MPA) and GnRH analogue therapies were effective, but a tumour mass was confirmed with rapid growth immediately after the cessation of treatment and led to her death from intra-tumour haemorrhage. The authors evaluated the mechanism of tumour using immunostaining for aromatase cytochrome P450. Results: The tumour showed high expression of aromatase. The immunostaining patterns of estrogen receptor (ER), progesterone receptor (PgR), and aromatase were similar to those of a premenopausal leiomyoma. Conclusion: It is likely that the tumour had the autocrine ability to secrete estrogen and that tumour growth resumed because of a flare-up caused by the downregulation of hormonal therapies.
Keywords
Leiomyomatosis peritonealis disseminata
Postmenopause
Malignant
Estradiol
Aromatase immunostaining
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