Successful therapy of a postpartum lymphangioleiomyomatosis. Case report and literature review

: Immediately after delivery a 17-year-old Turkish primipara developed edema, supraclavicular lymphoma and pleural effusion. CT-scans showed massive abdominal and mediastinal lymphoma. Lymphangioleiomyomatosis (LAM) was diagnosed by supraclavicular and retroperitoneal biopsy and progesterone receptors were documented in the tumor. There was no evidence of pulmonary involvement. 5 months' treatment with the LHRH-analogue goserelin showed neither clinical improvement nor regression of LAM. Irradiation of the ovaries and the abdomen with 30.2 Gy was followed by amenorrhea without immediate tumor remission. A follow-up examination 1 year later revealed clinical improvement and CT scans showed 50% abdominal and mediastinal regression of LAM. 5 1/2 years after diagnosis the asymptomatic patient is still in partial remission. Successful treatment of LAM is rare. We describe a case in which a major tumour reduction was documented by CT scanning.