ESR1 and disseminated peritoneal leiomyomatosis: The hypothesis was demonstrated in patients with pregnancy, or taking contraceptive, hormone replacement therapy or tamoxifen therapy, confirmed with estrogen-secreting tumors, or ovarian stimulation.[14–16] In addition, some researchers have found that lowering estrogen levels with GnRHa or aromatase inhibitors can make LPD tumor nodules regress.[16] The findings of ER and PR in LPD further proved the important role of hormones in the pathogenesis of LPD.[17] However, hormones are not the only cause of LPD.