Intraepithelial G3 adenocarcinoma of the endometrium after tamoxifen treatment

• Published in: Archives of gynecology and obstetrics 2005-01, Vol.271 (1), p.62-65
• Main Authors: Marchesoni, Diego, Driul, L, Mozzanega, B, Nardelli, G B, Parenti, A
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - chemically induced; Anticarcinogenic Agents - adverse effects; Antineoplastic Agents, Hormonal - adverse effects; Breast Neoplasms - drug therapy; Breast Neoplasms - surgery; Carcinoma in Situ - chemically induced; Carcinoma, Ductal - drug therapy; Carcinoma, Ductal - surgery; Chemotherapy, Adjuvant; Dilatation and Curettage; Endometrial cancer; Endometrial Neoplasms - chemically induced; Endometrium - drug effects; Endometrium - pathology; Female; Humans; Hysterectomy; Hysteroscopy; Mastectomy, Radical; Middle Aged; Tamoxifen - adverse effects
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-004-0668-0

In this paper we describe a case of endometrial carcinoma observed in a post-menopausal patient who was treated with tamoxifen for 5 years after a mastectomy for cancer. She came to our department because of vaginal bleeding 2 years after the end of tamoxifen treatment. She underwent hysteroscopy and a D and C. A polypoid endometrium completely filled the uterine cavity and was carefully removed by curettage; histology showed a highly undifferentiated neoplasia with a component of serous adenocarcinoma, which was likely to originate from endometrial polyps. The patient underwent radical hysterectomy, but no residual tumor was found in the uterus or in the tubes, ovary, or pelvic nodes, in spite of its low differentiation grade and high potential aggressiveness, and even though the patient was already symptomatic. Two years after surgery the patient is disease free, which is consistent with the evaluation of the surgical specimen, but unusual in poorly differentiated neoplasms.