Ceylan Yasin, Doğer Emek, Çakıroğlu Ahmet Yiğit, Vural Çiğdem, Yücesoy İzzet
Kocaeli University Faculty of Medicine, Department of Obstetrics and Gynecology Kocaeli, Turkey.
Kocaeli University Faculty of Medicine, Department of Pathology, Kocaeli, Turkey.
Turk J Obstet Gynecol. 2015 Dec;12(4):244-247. doi: 10.4274/tjod.44341. Epub 2015 Dec 15.
Mullerian adenosarcoma following tamoxifen therapy is a rare condition. Our aim was to report the youngest patient in the literature with uterine mullerian adenosarcoma who was undergoing tamoxifen therapy for breast cancer. A premenopausal woman aged 38 years who was undergoing tamoxifen therapy for breast cancer, was admitted with symptoms of lower abdominal pain and irregular vaginal bleeding and malodorous vaginal discharge that had continued for at least 6 months. A pelvic examination revealed a large and malodorous polypoid mass protruding through the cervix and an enlarged uterus. A biopsy from the protruding polypoid mass was reported as a large area of necrosis with neoplastic mesenchymal cells. The patient underwent a total abdominal hysterectomy, bilateral salpingo-oopherectomy, pelvic-paraaortic lymph node dissection, and omentectomie. The histologic diagnosis was Mullerian adenosarcoma. As a result, she was discharged to the oncology department. The woman is alive and her chemoradiotherapy treatment is ongoing. The role of tamoxifen therapy in the development of endometrial neoplasms remains unclear, but all cases of endometrial thickening and vaginal bleeding must be investigated for Mullerian adenosarcoma in tamoxifen users.
他莫昔芬治疗后发生的苗勒管腺肉瘤是一种罕见疾病。我们的目的是报告文献中最年轻的接受他莫昔芬治疗乳腺癌时发生子宫苗勒管腺肉瘤的患者。一名38岁的绝经前女性正在接受他莫昔芬治疗乳腺癌，因下腹部疼痛、不规则阴道出血及恶臭阴道分泌物症状入院，这些症状持续至少6个月。盆腔检查发现一个大的、恶臭的息肉样肿物经宫颈突出，子宫增大。突出的息肉样肿物活检报告为大片坏死伴肿瘤性间叶细胞。患者接受了全腹子宫切除术、双侧输卵管卵巢切除术、盆腔-腹主动脉旁淋巴结清扫术及大网膜切除术。组织学诊断为苗勒管腺肉瘤。结果，她被转至肿瘤科。该女性尚存活，其放化疗正在进行。他莫昔芬治疗在子宫内膜肿瘤发生中的作用仍不清楚，但对于使用他莫昔芬的患者，所有子宫内膜增厚和阴道出血病例都必须排查苗勒管腺肉瘤。
