Moffat D F, Oien K A, Dickson J, Habeshaw T, McLellan D R
University Department of Pathology, Western Infirmary, Glasgow, UK.
Ann Oncol. 2000 Sep;11(9):1195-6. doi: 10.1023/a:1008354429921.
We describe a case of hepatocellular carcinoma (HCC) after long term tamoxifen therapy in a 71-year-old woman. The patient was prescribed tamoxifen for 12 years following right mastectomy and axillary node clearance for breast carcinoma in 1985. In 1997, she complained of abdominal pain and fullness. An abdominal ultrasound scan showed lesions in the right lobe of liver which were thought to be metastases. However, a biopsy showed primary HCC. Studies in rats suggest that tamoxifen is involved in hepatic carcinogenesis but studies in humans have failed to show any increased risk. However, these studies followed up patients for less than five years. An increased risk of HCC may not become apparent until after a decade or more of tamoxifen therapy. In addition, HCC in tamoxifen treated patients may be under-reported since there may be reluctance to biopsy liver tumours which are assumed to be secondary carcinoma of the breast.
我们描述了一例71岁女性在长期服用他莫昔芬治疗后发生肝细胞癌（HCC）的病例。该患者于1985年因乳腺癌接受右乳房切除术和腋窝淋巴结清扫术后，服用他莫昔芬12年。1997年，她主诉腹痛和腹胀。腹部超声扫描显示肝脏右叶有病变，当时认为是转移瘤。然而，活检显示为原发性肝细胞癌。对大鼠的研究表明他莫昔芬与肝癌发生有关，但对人类的研究未能显示出任何风险增加。然而，这些研究对患者的随访时间不足五年。肝癌风险增加可能在他莫昔芬治疗十年或更长时间后才会显现。此外，接受他莫昔芬治疗的患者中肝癌可能报告不足，因为对于被认为是乳腺癌继发性癌的肝脏肿瘤，可能不愿进行活检。
