Abstract
OBJECTIVE: To determine the frequency of uterine leiomyomas and hysterectomy in patients with lymphangioleiomyomatosis (LAM), a disease characterized by proliferation of abnormal-appearing smooth muscle-like cells. DESIGN: Retrospective study. SETTING: Natural history study at the National Institutes of Health. PATIENT(S): 456 patients with sporadic LAM and LAM associated with tuberous sclerosis complex (LAM/TSC). INTERVENTION(S): Review of records and pelvic computed axial tomography scans. MAIN OUTCOME MEASURE(S): Prevalence of uterine leiomyomas and hysterectomy. RESULT(S): A total of 174 women had uterine leiomyomas (38%). One hundred eighteen were diagnosed by computed tomographic scan and 56 were diagnosed by hysterectomy. Among 323 patients who did not have hysterectomy, 105 of 270 patients (39%) with sporadic LAM and 13 of 53 (25%) with LAM/TSC had uterine leiomyomas. Hysterectomy was performed in 108 of 378 subjects with sporadic LAM and 25 of 78 with LAM/TSC. Fifty-six patients were found to have uterine fibroids on hysterectomy. The most common indications for hysterectomy were uterine leiomyoma, LAM, and endometriosis. CONCLUSION(S): Uterine leiomyomas are not more common in LAM than in the general population. However, in LAM, the frequency of hysterectomy is higher because of it having been recommended for treatment of LAM.