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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Main Authors: Jacopo Di Giuseppe, Leonardo Natalini, Mila Bordini, Daniele Crescenzi, Linda Grementieri, Jessica Petrucci, Arianna Asaro, Luca Giannella, Giovanni Delli Carpini, Camilla Grelloni, Andrea Ciavattini
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
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.
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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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