TSC1 and systemic lupus erythematosus: Though we have not yet performed genetic testing for germline mutations to reveal an association with mTOR pathway deregulation that may cause TSC, the presence of severe SLE, highly suggestive of constitutive hyperactivation of mTOR signaling, may lead to endometrial cancer as well as particularly aggressive LAM cells present in uterine myometrium and lymphogenously invading the retroperitoneal lymph nodes.