Diagnostic and therapeutic challenges in a case of disseminated parasitic, metastasizing and peritoneal leiomyomatosis: a complex approach

We describe a case presenting a rare combination of parasitic, metastasizing and disseminated peritoneal leiomyomatosis, challenging diagnosis and treatment. The patient initially presented with symptoms related to compression of pelvic structures, followed by the appearance of leiomyomas in the abdominal wall and finally leiomyomas distributed throughout the peritoneum and eventually associated with ascites. The differential diagnosis is broad and complex and includes metastases of primary tumors, among others. Moreover, the lack of a standard of treatment underlines the complexity of these pathologies, advocating a comprehensive surgical approach and considering pharmacological treatment options if there is gestational desire.