Pathophysiology and Possible Iatrogenic Cause of Leiomyomatosis Peritonealis Disseminata
Bibliographic record
Abstract
We present a case of leiomyomatosis peritonealis disseminata (LPD) after myoma morcellation and review the literature using the keywords leiomyomatosis peritonealis disseminata and disseminated peritoneal leiomyomatosis. The search was conducted in Medline, EMBASE, and Cochrane Database of systematic reviews. We encountered 132 cases of LPD in the English literature; 113 in the reproductive age group, 7 in postmenopausal women, 6 in males, and another in a horse. The possible causes could be divided into hormonal, subperitoneal mesenchymal stem cells, metaplasia, genetic, or iatrogenic after morcellation of myoma during laparoscopic surgery. Our case and 4 others reported in the literature support the contribution of the iatrogenic theory. It appears that LPD could be due to metaplasia of mesenchymal cells of the peritoneum and, in susceptible women, leaving fragments of myoma in the abdominal cavity might contribute to the development of LPD. Accordingly, one should avoid leaving fragments of the uterus or myoma tissue in the abdominal cavity after morcellation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".