一名年轻乳腺癌患者产后出现的子宫内膜输卵管化生
Endometrial tubal metaplasia in a young puerperal woman after breast cancer.
作者信息
Di Benedetto Luisa, Giovanale Valentina, Caserta Donatella
机构信息
Department of Medical and Surgical Sciences and Translational Medicine, "Sapienza", University of Rome, S. Andrea Hospital Rome, Italy.
出版信息
Int J Clin Exp Pathol. 2015 Jun 1;8(6):7610-3. eCollection 2015.
INTRODUCTION
Tamoxifen is the usual endocrine (anti-estrogen) therapy for hormone receptor-positive breast cancer in pre and post-menopausal women. Previous studies have suggested an increased prevalence of endometrial diseases after treatment with tamoxifen.
CASE PRESENTATION
The authors report a case of 38-year-old woman with diagnosis of endometrial polyp and tubal metaplasia, during puerperium and after micropapillary ductal breast cancer surgery, 5 years of tamoxifen treatment, spontaneous pregnancy without complications and full-term vaginal delivery.
CONCLUSION
Tamoxifen is a safe and reliable treatment of breast cancer, but data suggest an association with endometrial polyps, hyperplasia, metaplasia and carcinoma. One of the most common types of endometrial metaplasia is ciliated tubal metaplasia. It is generally known that endometrial tubal metaplasia is a benign disease. However studies propose endometrial tubal metaplasia to be a potential premalignant endometrial lesion and its association with endometrial hyperplasia and well-differentiated endometrioid carcinoma. We propose close monitoring of patients taking tamoxifen and prompt evaluation of any uterine bleeding or pelvic complaint or abnormal TVUS images.
引言
他莫昔芬是绝经前和绝经后激素受体阳性乳腺癌的常用内分泌（抗雌激素）治疗药物。既往研究提示，他莫昔芬治疗后子宫内膜疾病的患病率增加。
病例报告
作者报告了一例38岁女性，诊断为子宫内膜息肉和输卵管化生，处于产褥期，曾接受微乳头导管性乳腺癌手术，服用他莫昔芬5年，自然受孕且无并发症，足月阴道分娩。
结论
他莫昔芬是一种安全可靠的乳腺癌治疗药物，但数据表明其与子宫内膜息肉、增生、化生及癌有关。子宫内膜化生最常见的类型之一是纤毛输卵管化生。一般认为子宫内膜输卵管化生是一种良性疾病。然而，研究表明子宫内膜输卵管化生可能是一种潜在的子宫内膜癌前病变，且与子宫内膜增生和高分化子宫内膜样癌有关。我们建议对服用他莫昔芬的患者进行密切监测，并对任何子宫出血、盆腔不适或经阴道超声图像异常进行及时评估。
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