Low‐grade endometrial stromal sarcoma developing in a postmenopausal woman under toremifene treatment for breast cancer

Low‐grade endometrial stromal sarcoma (ESS) is a rare neoplasm that is generally estrogen‐receptor‐ and progesterone‐receptor‐positive and develops in premenopausal women. Although tamoxifen treatment is associated with an increased risk of ESS, the effect of other selective estrogen receptor modula...

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Bibliographic Details
Published in:The journal of obstetrics and gynaecology research 2013-01, Vol.39 (1), p.424-429
Main Authors: Kashiyama, Tomoko, Oda, Katsutoshi, Kawana, Kei, Arimoto, Takahide, Kanetaka, Yukiko, Takazawa, Yutaka, Maeda, Daichi, Nakagawa, Shunsuke, Yano, Tetsu, Kozuma, Shiro
Format: Article
Language:English
Subjects:
Antineoplastic Agents, Hormonal - adverse effects
Antineoplastic Agents, Hormonal - therapeutic use
Breast Neoplasms - drug therapy
Breast Neoplasms - pathology
Breast Neoplasms - surgery
Chemotherapy, Adjuvant
Disease-Free Survival
Endometrial Neoplasms - chemically induced
Endometrial Neoplasms - pathology
Endometrial Neoplasms - surgery
estrogen‐like effect
Female
Humans
Hysterectomy
low‐grade endometrial stromal sarcoma
Middle Aged
Postmenopause
Sarcoma, Endometrial Stromal - chemically induced
Sarcoma, Endometrial Stromal - pathology
Sarcoma, Endometrial Stromal - surgery
selective estrogen receptor modulator
toremifene
Toremifene - adverse effects
Toremifene - therapeutic use
uterine corpus
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Summary:Low‐grade endometrial stromal sarcoma (ESS) is a rare neoplasm that is generally estrogen‐receptor‐ and progesterone‐receptor‐positive and develops in premenopausal women. Although tamoxifen treatment is associated with an increased risk of ESS, the effect of other selective estrogen receptor modulators, including toremifene, on the risk of ESS is not clear. A 61‐year‐old postmenopausal woman was treated with toremifene as an adjuvant therapy for breast cancer. A cystic mass developed during the treatment, with gradual growth in the uterine myometrium. The patient was treated with hysterectomy and bilateral salpingo‐oophorectomy, and the tumor was diagnosed as low‐grade ESS (stage IA) with estrogen‐receptor and progesterone‐receptor. The patient discontinued toremifene and has been progression‐free for 21 months. Our data suggest that toremifene might be associated with the development of ESS in certain patients through its estrogen‐like effects in the uterus.
ISSN:1341-8076
1447-0756
DOI:10.1111/j.1447-0756.2012.01915.x