ESR1 and tuberous sclerosis: In immunohistochemistry examination, positives results were obtained in human melanoma black 45 (10/25, 40%), smooth muscle actin (19/25, 76%), estrogen receptor (4/25, 16%), Pathology results showed spindle cells in 4 patients with TSC-LAM (44.4%) and 13 patients with S-AM (48.1%).