Gherman R B, Parker M F, Macri C I
Department of Obstetrics and Gynecology, Bethesda Naval Hospital, National Naval Medical Center, Bethesda, Maryland, USA.
Obstet Gynecol. 1994 Oct;84(4 Pt 2):717-9.
Increased attention has been focused recently on the estrogenic effects of tamoxifen. Review of the literature reveals an association between tamoxifen use and gynecologic tumors.
A 52-year-old postmenopausal woman was treated with tamoxifen for stage II estrogen receptor-positive breast carcinoma. Her aspartate transaminase and alanine transaminase levels increase markedly after 6 months of tamoxifen use. After an additional 17 months of elevated serum transaminases, the patient was found to have a stage Ic granulosa cell tumor of the ovary.
Patients with tamoxifen-induced liver dysfunction may be at increased risk for granulosa cell tumors because of alterations in tamoxifen metabolism.
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