Treatment of Lymphangioleiomyomatosis

To the Editor: The article on lymphangioleiomyomatosis (LAM) by Taylor et al. (Nov. 1 issue)* was a very useful addition to the limited literature on the disease. I take issue with one of their recommendations, however. Despite their own finding that oophorectomy is not associated with an observable clinical benefit, they continue to recommend it as second-line therapy because studies to date cannot exclude a possible benefit. Perhaps the following hypothetical encounter with a patient will illustrate my point. "Mr. Jones, your open-lung biopsy showed a form of interstitial lung disease about which we know very little. The natural history . . .