In Reply: Dr Franz notes that our finding of
8 patients with meningiomas among patients with LAM is not remarkable because
it is not much greater than the rate of 1.4% found at autopsy. Because the
incidence of meningiomas increases with age,1
comparison with an autopsy series is not valid. In fact, in 1000 healthy volunteers
similar in age to our population and studied with MRI, none was found to have
a meningioma, consistent with an age-dependent increase in incidence.2 As an update, since publication of our article
a ninth patient in the series of 250 has been diagnosed as having meningioma.
We stand by our original conclusions that the incidence of meningiomas in
LAM is much greater than expected.
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