COL4A5 and deafness: Other examples of syndromes with leiomyomas as one of the manifestations include hereditary leiomyomatosis and renal cell carcinoma, which is characterized by germline alterations in the FH gene, leading to cutaneous leiomyomas, uterine leiomyomas, and papillary renal cell carcinoma [19], as well as Alport syndrome (COL4A5 and COL4A6 alterations), which is characterized by nephropathy, deafness, ocular anomalies, and diffuse leiomyomatosis that can involve the esophagus, tracheobronchial region, and uterus [20].