A Case of Uterine Lymphangioleiomyomatosis Complicated by Tuberous Sclerosis Complex

Lymphangioleiomyomatosis (LAM) is one of the presentations of perivascular epithelioid cell neoplasm that is frequently complicated by tuberous sclerosis complex (TSC). Here, we report an uncommon case of uterine LAM treated with everolimus, which is a mechanistic target of rapamycin (mTOR) inhibito...

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Main Authors: Kaori Yamada, Yukio Yamanishi, Junichi Aratake, Nanayo Sasagasako, Yoshihide Inayama, Rei Gou, Atsuko Kawamura, Megumi Yamanishi, Kenzo Kosaka
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Case Reports in Obstetrics and Gynecology
Online Access:http://dx.doi.org/10.1155/2022/2893975
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author Kaori Yamada
Yukio Yamanishi
Junichi Aratake
Nanayo Sasagasako
Yoshihide Inayama
Rei Gou
Atsuko Kawamura
Megumi Yamanishi
Kenzo Kosaka
author_facet Kaori Yamada
Yukio Yamanishi
Junichi Aratake
Nanayo Sasagasako
Yoshihide Inayama
Rei Gou
Atsuko Kawamura
Megumi Yamanishi
Kenzo Kosaka
author_sort Kaori Yamada
collection DOAJ
description Lymphangioleiomyomatosis (LAM) is one of the presentations of perivascular epithelioid cell neoplasm that is frequently complicated by tuberous sclerosis complex (TSC). Here, we report an uncommon case of uterine LAM treated with everolimus, which is a mechanistic target of rapamycin (mTOR) inhibitor. A 42-year-old female patient (gravida 0) with a history of TSC presented with abdominal pain. Pelvic magnetic resonance imaging showed multiple masses in the uterine myometrium, suggesting tumors that may contain internal hemorrhagic components. The lesions were suspected as the root cause of her symptoms. After everolimus was administered for a previously diagnosed renal angiolipoma, her uterine tumors temporarily decreased in size. Subsequently, laparoscopic hysterectomy and bilateral salpingectomy were performed since she could not tolerate everolimus for a long period due to the medication’s side effects. Furthermore, the patient was diagnosed with LAM through histopathological examination after surgical resection. Therefore, it is advisable to suspect and investigate uterine LAM when a patient with a history of TSC presents with irregular genital bleeding or abdominal pain. Moreover, mTOR inhibitors may be a treatment option, in addition to surgery, in cases of uterine LAM exacerbation.
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spelling doaj-art-e43ea2087f794736b1b331cb9fb0a1222025-02-03T06:05:51ZengWileyCase Reports in Obstetrics and Gynecology2090-66922022-01-01202210.1155/2022/2893975A Case of Uterine Lymphangioleiomyomatosis Complicated by Tuberous Sclerosis ComplexKaori Yamada0Yukio Yamanishi1Junichi Aratake2Nanayo Sasagasako3Yoshihide Inayama4Rei Gou5Atsuko Kawamura6Megumi Yamanishi7Kenzo Kosaka8Department of Obstetrics and GynecologyDepartment of Obstetrics and GynecologyDepartment of Obstetrics and GynecologyDepartment of Obstetrics and GynecologyDepartment of Obstetrics and GynecologyDepartment of Obstetrics and GynecologyDepartment of Obstetrics and GynecologyDepartment of Obstetrics and GynecologyDepartment of Obstetrics and GynecologyLymphangioleiomyomatosis (LAM) is one of the presentations of perivascular epithelioid cell neoplasm that is frequently complicated by tuberous sclerosis complex (TSC). Here, we report an uncommon case of uterine LAM treated with everolimus, which is a mechanistic target of rapamycin (mTOR) inhibitor. A 42-year-old female patient (gravida 0) with a history of TSC presented with abdominal pain. Pelvic magnetic resonance imaging showed multiple masses in the uterine myometrium, suggesting tumors that may contain internal hemorrhagic components. The lesions were suspected as the root cause of her symptoms. After everolimus was administered for a previously diagnosed renal angiolipoma, her uterine tumors temporarily decreased in size. Subsequently, laparoscopic hysterectomy and bilateral salpingectomy were performed since she could not tolerate everolimus for a long period due to the medication’s side effects. Furthermore, the patient was diagnosed with LAM through histopathological examination after surgical resection. Therefore, it is advisable to suspect and investigate uterine LAM when a patient with a history of TSC presents with irregular genital bleeding or abdominal pain. Moreover, mTOR inhibitors may be a treatment option, in addition to surgery, in cases of uterine LAM exacerbation.http://dx.doi.org/10.1155/2022/2893975
spellingShingle Kaori Yamada
Yukio Yamanishi
Junichi Aratake
Nanayo Sasagasako
Yoshihide Inayama
Rei Gou
Atsuko Kawamura
Megumi Yamanishi
Kenzo Kosaka
A Case of Uterine Lymphangioleiomyomatosis Complicated by Tuberous Sclerosis Complex
Case Reports in Obstetrics and Gynecology
title A Case of Uterine Lymphangioleiomyomatosis Complicated by Tuberous Sclerosis Complex
title_full A Case of Uterine Lymphangioleiomyomatosis Complicated by Tuberous Sclerosis Complex
title_fullStr A Case of Uterine Lymphangioleiomyomatosis Complicated by Tuberous Sclerosis Complex
title_full_unstemmed A Case of Uterine Lymphangioleiomyomatosis Complicated by Tuberous Sclerosis Complex
title_short A Case of Uterine Lymphangioleiomyomatosis Complicated by Tuberous Sclerosis Complex
title_sort case of uterine lymphangioleiomyomatosis complicated by tuberous sclerosis complex
url http://dx.doi.org/10.1155/2022/2893975
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