Diagnosis, treatment and clinical outcomes of extrauterine sites of leiomyomatosis: a systematic review
Background This review aims to provide a comprehensive description of the clinical presentation, treatment, and histopathological features of extrauterine sites of leiomyomatosis (ESL), such as disseminated peritoneal leiomyomatosis (DPL), parasitic myoma (PM), benign metastatic leiomyoma (BML), and...
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2546681 |
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| author | Jacopo Di Giuseppe Leonardo Natalini Mila Bordini Daniele Crescenzi Linda Grementieri Jessica Petrucci Arianna Asaro Luca Giannella Giovanni Delli Carpini Camilla Grelloni Andrea Ciavattini |
| author_facet | Jacopo Di Giuseppe Leonardo Natalini Mila Bordini Daniele Crescenzi Linda Grementieri Jessica Petrucci Arianna Asaro Luca Giannella Giovanni Delli Carpini Camilla Grelloni Andrea Ciavattini |
| author_sort | Jacopo Di Giuseppe |
| collection | DOAJ |
| description | Background This review aims to provide a comprehensive description of the clinical presentation, treatment, and histopathological features of extrauterine sites of leiomyomatosis (ESL), such as disseminated peritoneal leiomyomatosis (DPL), parasitic myoma (PM), benign metastatic leiomyoma (BML), and intravascular leiomyoma (IVL). The impact of previous surgery (hysterectomy or myomectomy) on development of intra-abdominal extrauterine leiomyomas (IAELs) and extra-abdominal extrauterine leiomyomas (EAELs) has been evaluated.Methods According to PRISMA guidelines, we searched PubMed, Scopus, and Web of Science databases. Relevant articles were retrieved in full-text format and screened based on predefined inclusion and exclusion criteria.Results 358 studies (372 cases) are included. Among IAELs, the most common symptom is abdominopelvic pain (63.9% of DPL, and 69.2% of PMs cases, respectively). In contrast, EAELs exhibit heterogeneous clinical presentations; dyspnea is the most common symptom (29.7% of BML, and 29.9% of IVL cases, respectively). 68.8% of DPL, 60% of PM, 89.7% of BML, and 56.4% of IVL patients underwent previous uterine surgery. A significant association (p = 0.0417) between the type of previous uterine surgery (hysterectomy and myomectomy) and the subsequent location of ESLs is found (68.7% VS 51.4% in EAELs, 31.3% VS 48.6% in IAELs, respectively).Conclusions DPL, PM, BML, and IVL exhibit overlapping characteristics, requiring a multimodal approach that includes imaging, histopathology, and surgical or medical management. Greater awareness among clinicians is needed regarding surgical procedures involving ligation and/or cutting of major uterine vessels, which appear to contribute to the development of EAELs, and morcellation, which tends to promote intraperitoneal metastatic spread. |
| format | Article |
| id | doaj-art-ebbc703a0f21406eb2b9645cb772b68e |
| institution | Kabale University |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-ebbc703a0f21406eb2b9645cb772b68e2025-08-21T13:08:00ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2546681Diagnosis, treatment and clinical outcomes of extrauterine sites of leiomyomatosis: a systematic reviewJacopo Di Giuseppe0Leonardo Natalini1Mila Bordini2Daniele Crescenzi3Linda Grementieri4Jessica Petrucci5Arianna Asaro6Luca Giannella7Giovanni Delli Carpini8Camilla Grelloni9Andrea Ciavattini10Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, ItalyObstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, ItalyObstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, ItalyObstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, ItalyObstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, ItalyObstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, ItalyObstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, ItalyObstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, ItalyObstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, ItalyObstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, ItalyObstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, ItalyBackground This review aims to provide a comprehensive description of the clinical presentation, treatment, and histopathological features of extrauterine sites of leiomyomatosis (ESL), such as disseminated peritoneal leiomyomatosis (DPL), parasitic myoma (PM), benign metastatic leiomyoma (BML), and intravascular leiomyoma (IVL). The impact of previous surgery (hysterectomy or myomectomy) on development of intra-abdominal extrauterine leiomyomas (IAELs) and extra-abdominal extrauterine leiomyomas (EAELs) has been evaluated.Methods According to PRISMA guidelines, we searched PubMed, Scopus, and Web of Science databases. Relevant articles were retrieved in full-text format and screened based on predefined inclusion and exclusion criteria.Results 358 studies (372 cases) are included. Among IAELs, the most common symptom is abdominopelvic pain (63.9% of DPL, and 69.2% of PMs cases, respectively). In contrast, EAELs exhibit heterogeneous clinical presentations; dyspnea is the most common symptom (29.7% of BML, and 29.9% of IVL cases, respectively). 68.8% of DPL, 60% of PM, 89.7% of BML, and 56.4% of IVL patients underwent previous uterine surgery. A significant association (p = 0.0417) between the type of previous uterine surgery (hysterectomy and myomectomy) and the subsequent location of ESLs is found (68.7% VS 51.4% in EAELs, 31.3% VS 48.6% in IAELs, respectively).Conclusions DPL, PM, BML, and IVL exhibit overlapping characteristics, requiring a multimodal approach that includes imaging, histopathology, and surgical or medical management. Greater awareness among clinicians is needed regarding surgical procedures involving ligation and/or cutting of major uterine vessels, which appear to contribute to the development of EAELs, and morcellation, which tends to promote intraperitoneal metastatic spread.https://www.tandfonline.com/doi/10.1080/07853890.2025.2546681HysterectomyLeiomyomalaparoscopylaparotomymyomectomymorcellation |
| spellingShingle | Jacopo Di Giuseppe Leonardo Natalini Mila Bordini Daniele Crescenzi Linda Grementieri Jessica Petrucci Arianna Asaro Luca Giannella Giovanni Delli Carpini Camilla Grelloni Andrea Ciavattini Diagnosis, treatment and clinical outcomes of extrauterine sites of leiomyomatosis: a systematic review Annals of Medicine Hysterectomy Leiomyoma laparoscopy laparotomy myomectomy morcellation |
| title | Diagnosis, treatment and clinical outcomes of extrauterine sites of leiomyomatosis: a systematic review |
| title_full | Diagnosis, treatment and clinical outcomes of extrauterine sites of leiomyomatosis: a systematic review |
| title_fullStr | Diagnosis, treatment and clinical outcomes of extrauterine sites of leiomyomatosis: a systematic review |
| title_full_unstemmed | Diagnosis, treatment and clinical outcomes of extrauterine sites of leiomyomatosis: a systematic review |
| title_short | Diagnosis, treatment and clinical outcomes of extrauterine sites of leiomyomatosis: a systematic review |
| title_sort | diagnosis treatment and clinical outcomes of extrauterine sites of leiomyomatosis a systematic review |
| topic | Hysterectomy Leiomyoma laparoscopy laparotomy myomectomy morcellation |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2546681 |
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