Three out of eight of the FDR < 0.05 transcripts, Maff, Atf4, JunD, were increased in LPD (all P < 0.0001) and are associated with the Mitogen-activated protein kinase (MAPK) pathway, a network of serial kinases with downstream effectors that target genes to coordinate cell proliferation, differentiation, apoptosis and stress response [28, 29]. Here, ATF4 is linked to disseminated peritoneal leiomyomatosis.