Logmans A, Mous H V, Bontenbal M, Beerman H, van Lent M
Department of Oncologic Gynecology, Dr. Daniel den Hoed Cancer Center, Rotterdam, The Netherlands.
Eur J Obstet Gynecol Reprod Biol. 1994 Sep;56(3):173-6. doi: 10.1016/0028-2243(94)90166-x.
Tamoxifen and megestrol acetate are used as a hormonal treatment for metastatic breast carcinoma. It is suggested that the use of tamoxifen may induce endometrial cancer. In this article we describe nine patients under hormonal treatment for metastatic breast cancer with, firstly, tamoxifen and, later, megestrol acetate. These nine patients all had symptoms of postmenopausal vaginal blood loss during therapy with megestrol acetate, an indication to perform a diagnostic dilatation and curettage. By histopathological examination the curettings showed a decidualized stroma with an infiltration of lymphocytes, some plasma cells and many eosinophils. In none of the patients was atypical hyperplasia or malignancy found. The dilatation and curettage had also a therapeutic effect, since only one of the patients still had complaints, while the other eight did not complain of postmenopausal bleeding again. We review the literature and discuss the value of a diagnostic dilatation and curettage.
他莫昔芬和醋酸甲地孕酮被用作转移性乳腺癌的激素治疗药物。有人认为使用他莫昔芬可能会诱发子宫内膜癌。在本文中，我们描述了9例接受转移性乳腺癌激素治疗的患者，这些患者首先使用他莫昔芬，随后使用醋酸甲地孕酮。这9例患者在使用醋酸甲地孕酮治疗期间均出现绝经后阴道出血症状，这表明需要进行诊断性刮宫。通过组织病理学检查，刮出物显示有蜕膜化的间质，伴有淋巴细胞、一些浆细胞和许多嗜酸性粒细胞浸润。所有患者均未发现非典型增生或恶性病变。刮宫术也有治疗作用，因为只有1例患者仍有症状，而其他8例患者未再出现绝经后出血的症状。我们回顾了相关文献并讨论了诊断性刮宫的价值。
