title: Malignant presentation of uterine lymphangioleiomyomatosis.
abstract: OBJECTIVE
  The main aim of this case report was to present the method of diagnosis, management, and the 12-year-follow-up of a patient diagnosed with primary uterine lymphangioleiomyomatosis (LAM).
  
  
  METHODS
  A 47-year-old woman was admitted to the Department of Thoracosurgery due to pulmonary lesions suspected to be metastatic. The potential primary site of the neoplasm was not identified by previous imaging studies and specialist counseling. The patient had a history of total abdominal hysterectomy without ovaries due to a uterine tumor recognized as cellular leiomyoma and left salpingo-oophorectomy due to a solid ovarian tumor also recognized as leiomyoma. She had previously undergone the removal of a left kidney angiomyolipoma. After histopathological examination of the pulmonary lesions and repeated evaluation of the ovarian and uterine tumors, the diagnosis of primary uterine LAM with metastases to the ovary and the lungs was established. Although new metastatic lesions occurred, the patient remained in good condition during the 12-year-follow-up.
  
  
  CONCLUSIONS
  The history of our patient and review of the literature suggest that although uterine LAM presents malignant features (i.e., metastasis), the disease is long lasting and the patient can be in good condition for a number of years.
authors.affiliation: Division of Gynecological Surgery, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Szpurek
authors.affiliation: Division of Gynecological Surgery, Poznan University of Medical Sciences, Poznan, Poland. Electronic address: szuberts@o2.pl.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Szubert
authors.affiliation: Department of Thoracosurgery, Wielkopolska Center of Pulmonology and Thoracosurgery, Poznan, Poland.
authors.forename: Pawel
authors.initials: P
authors.lastname: Zielinski
authors.affiliation: Department of Pathology, Clinical Hospital of Obstetrics and Gynecology, Poznan, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Frankowski
authors.affiliation: Division of Gynecological Surgery, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Sajdak
authors.affiliation: Division of Gynecological Surgery, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Rafal
authors.initials: R
authors.lastname: Moszynski
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007813:Laparotomy; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D018192:Lymphangioleiomyomatosis / Q000175:diagnosis* / Q000601:surgery; D008875:Middle Aged; D010052:Ovariectomy / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery
keywords: genital track; lymphangioleiomyomatosis; metastasis; tuberous sclerosis; uterus