Department of Obstetrics & Gynecology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA.
Department of Obstetrics & Gynecology, Zucker School of Medicine at Hofstra/Northwell and NorthwellHealth, Hempstead, NY, USA.
Climacteric. 2022 Jun;25(3):235-239. doi: 10.1080/13697137.2021.1990259. Epub 2021 Oct 25.
We report and review the clinical effectiveness of aromatase inhibitors in a patient with refractory, recurrent and infiltrating endometriosis. We demonstrate excellent clinical, radiological and endoscopic responses after failure of multiple other modalities. Our case and the literature show that single-agent letrozole is capable to treat deep infiltrative endometriosis involving the rectum and the urinary tract. The use of aromatase inhibitor treatment of endometriosis in postmenopausal women makes sense, is safe and is well tolerated. Difficult cases of deep infiltrative endometriosis might require use of combined surgical and medical treatment modalities. Multidisciplinary involvement of the gynecologist, bowel surgeon, urologist and invasive radiologist might be needed. Aromatase inhibitors should be considered to be an integral part of the armamentarium in the management of women with endometriosis, especially in refractory cases that have failed conventional therapeutic modalities.
我们报告并回顾了芳香酶抑制剂在一位难治性、复发性和浸润性子宫内膜异位症患者中的临床疗效。在多种其他治疗方法失败后，我们观察到了出色的临床、影像学和内镜反应。我们的病例和文献表明，来曲唑单药治疗可有效治疗累及直肠和泌尿道的深部浸润性子宫内膜异位症。绝经后妇女使用芳香酶抑制剂治疗子宫内膜异位症有意义、安全且耐受良好。深部浸润性子宫内膜异位症的疑难病例可能需要联合手术和药物治疗方法。妇科医生、肠道外科医生、泌尿科医生和介入放射科医生的多学科参与可能是必要的。芳香酶抑制剂应被视为子宫内膜异位症患者治疗方案的重要组成部分，特别是在常规治疗方法失败的难治性病例中。
