{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:39:36Z","timestamp":1782603576427,"version":"3.54.5"},"reference-count":24,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2018,8,9]],"date-time":"2018-08-09T00:00:00Z","timestamp":1533772800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Disseminated peritoneal leiomyomatosis (DPL) is a rare condition that is characterized by the presence of multiple subperitoneal or peritoneal smooth muscle nodules of varying sizes on the omentum and peritoneal surfaces, grossly mimicking disseminated carcinoma. DPL usually develops in premenopausal women with a benign course, and it is often found incidentally during abdominal surgery. Malignant transformation is a rare clinical course of DPL. Only a few studies have focused on DPL transformation into a leiomyosarcoma. Herein, we describe the case of a 61-year-old woman with a history of recurrent leiomyoma of the uterus who presented with intermittent progressive abdominal pain. The imaging study revealed a huge heterogeneous density mass in the pelvic region with pulmonary and hepatic metastases. Exploratory laparotomy and debulking surgery were performed, and showed the coexistence of DPL and leiomyosarcoma. She died approximately one month after the diagnosis because of rapid progression of pleural effusion due to malignancy. This case highlights the clinical features of DPL and its malignant transformation and metastasis so physicians can make an early diagnosis and provide timely management.<\/jats:p>","DOI":"10.3390\/jcm7080207","type":"journal-article","created":{"date-parts":[[2018,8,9]],"date-time":"2018-08-09T10:36:31Z","timestamp":1533810991000},"page":"207","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Epithelial-Mesenchymal Transition with Malignant Transformation Leading Multiple Metastasis from Disseminated Peritoneal Leiomyomatosis"],"prefix":"10.3390","volume":"7","author":[{"given":"Hsiao-Chen","family":"Chiu","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei 231, Taiwan"},{"name":"Department of Obstetrics and Gynecology, School of Medicine, Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8773-1847","authenticated-orcid":false,"given":"Meng-Yu","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei 231, Taiwan"},{"name":"Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao-Hsu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei 231, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su-Cheng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei 231, Taiwan"},{"name":"Department of Obstetrics and Gynecology, School of Medicine, Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giou-Teng","family":"Yiang","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei 231, Taiwan"},{"name":"Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsuan-Shang","family":"Yen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei 231, Taiwan"},{"name":"Department of Obstetrics and Gynecology, School of Medicine, Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Lin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Show Chwan Memorial Hospital, Changhua 500, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3773-9015","authenticated-orcid":false,"given":"Chia-Jung","family":"Li","sequence":"additional","affiliation":[{"name":"Research Assistant Center, Show Chwan Memorial Hospital, Changhua 500, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woei-Yau","family":"Kao","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei 231, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,8,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"957","DOI":"10.3892\/mco.2016.848","article-title":"Leiomyomatosis peritonealis disseminata: A case report and review of the literature","volume":"4","author":"Wu","year":"2016","journal-title":"Mol. Clin. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Halama, N., Grauling-Halama, S.A., and Daboul, I. (2005). Familial clustering of Leiomyomatosis peritonealis disseminata: An unknown genetic syndrome?. BMC Gastroenterol., 5.","DOI":"10.1186\/1471-230X-5-33"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/0002-9378(90)91205-Q","article-title":"Malignant leiomyomatosis peritonealis disseminata","volume":"163","author":"Akkersdijk","year":"1990","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_4","first-page":"126","article-title":"Malignant leiomyomatosis peritonealis disseminata","volume":"68","author":"Rubin","year":"1986","journal-title":"Obstet. Gynecol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1006\/gyno.1996.0138","article-title":"Malignant degeneration in leiomyomatosis peritonealis disseminata","volume":"61","author":"Raspagliesi","year":"1996","journal-title":"Gynecol. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/0002-9378(93)90130-B","article-title":"Computed tomography of leiomyomatosis peritonealis disseminata with malignant transformation","volume":"169","author":"Abulafia","year":"1993","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1007\/s002619900421","article-title":"Leiomyomatosis peritonealis disseminata complicated by sarcomatous transformation and ovarian torsion: Presentation of two cases and review of the literature","volume":"23","author":"Fulcher","year":"1998","journal-title":"Abdom. Imaging"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1006\/gyno.1999.5490","article-title":"Leiomyomatosis peritonealis disseminata: Does malignant transformation occur?","volume":"75","author":"Bekkers","year":"1999","journal-title":"A literature review. Gynecol. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S0020-7292(98)00255-0","article-title":"Leiomyomatosis peritonealis disseminata with malignant transformation","volume":"66","author":"Morizaki","year":"1999","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1016\/j.ygyno.2004.09.007","article-title":"Leiomyomatosis peritonealis disseminata with malignant change in a post-menopausal woman","volume":"95","author":"Sharma","year":"2004","journal-title":"Gynecol. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Tun, A.M., Tun, N.M., Zin Thein, K., Naing, E.E., Giashuddin, S., and Shulimovich, M. (2016). A Rare Concurrence of Leiomyomatosis Peritonealis Disseminata, Leiomyosarcoma of the Pelvis and Leiomyomatous Nodule of the Liver. Case Rep. Oncol. Med., 2016.","DOI":"10.1155\/2016\/3025432"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"426","DOI":"10.12659\/PJR.902242","article-title":"Imaging Findings in a Rare Case of Leiomyomatosis Peritonealis Disseminata with Malignant Transformation","volume":"82","author":"Syed","year":"2017","journal-title":"Pol. J. Radiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1159\/000274487","article-title":"Pathophysiology and possible iatrogenic cause of leiomyomatosis peritonealis disseminata","volume":"69","author":"Tulandi","year":"2010","journal-title":"Gynecol. Obstet. Investig."},{"key":"ref_14","first-page":"422","article-title":"Leiomyomatosis peritonealis disseminata presenting with intravascular extension and coexisting with endometriosis: A case report","volume":"52","author":"Haberal","year":"2007","journal-title":"J. Reprod. Med."},{"key":"ref_15","first-page":"1161","article-title":"Mullerianosis","volume":"22","author":"Batt","year":"2007","journal-title":"Histol. Histopathol."},{"key":"ref_16","first-page":"221","article-title":"Disseminated peritoneal leiomyomatosis associated with endometriosis","volume":"6","author":"Dauge","year":"1986","journal-title":"Apropos of a case. Ann. Pathol."},{"key":"ref_17","first-page":"258","article-title":"Leiomyomatosis peritonealis disseminata (LPD) with associated endometriosis: A case report","volume":"39","author":"Gana","year":"1994","journal-title":"J. R. Coll. Surg. Edinb."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/S0301-2115(97)00173-5","article-title":"Leiomyomatosis peritonealis disseminata associated with endometriosis: A case report and literature review","volume":"76","author":"Herrero","year":"1998","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1016\/j.fertnstert.2010.04.030","article-title":"Pathogenesis of a parauterine uterus-like mass: Developmentally misplaced mullerian tissue\u2014Mullerianosis","volume":"94","author":"Batt","year":"2010","journal-title":"Fertil. Steril."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1038\/nrc.2017.118","article-title":"EMT in cancer","volume":"18","author":"Brabletz","year":"2018","journal-title":"Nat. Rev. Cancer"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"4556","DOI":"10.1158\/0008-5472.CAN-17-0032","article-title":"Epithelial-to-Mesenchymal and Mesenchymal-to-Epithelial Transition in Mesenchymal Tumors: A Paradox in Sarcomas?","volume":"77","author":"Sannino","year":"2017","journal-title":"Cancer Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2405","DOI":"10.1074\/mcp.M110.000240","article-title":"Integrated proteomics and genomics analysis reveals a novel mesenchymal to epithelial reverting transition in leiomyosarcoma through regulation of slug","volume":"9","author":"Yang","year":"2010","journal-title":"Mol. Cell Prot."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1111\/aogs.12549","article-title":"Leiomyomatosis peritonealis disseminata of unusual course with malignant transformation: Case report","volume":"94","author":"Dzieniecka","year":"2015","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_24","first-page":"702","article-title":"Leiomyomatosis peritonealis disseminata with malignant degeneration. A case report","volume":"32","author":"Lamarca","year":"2011","journal-title":"Eur. J. Gynaecol. Oncol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/7\/8\/207\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T15:17:44Z","timestamp":1760195864000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/7\/8\/207"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,9]]},"references-count":24,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2018,8]]}},"alternative-id":["jcm7080207"],"URL":"https:\/\/doi.org\/10.3390\/jcm7080207","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,9]]}}}