Intestinal and pelvic endometriosis presenting as a tumor and associated with tamoxifen therapy: report of a case.

BACKGROUND: Tamoxifen has been used in the adjuvant treatment of breast cancer because of its antiestrogenic effects. However, recent reports have shown it to have estrogenic effects as well. The purpose of this report is to describe a potential association between tamoxifen therapy and endometriosis. CASE: A 50-year-old postmenopausal woman who had received 2 years of adjuvant tamoxifen therapy for breast carcinoma developed extensive tumor-like endometriosis necessitating extensive pelvic and intestinal surgery. CONCLUSION: This case report highlights the need for obstetricians and gynecologists to be familiar with the actions of tamoxifen and its potential complications.

Osteomyelosclerosis with granulocytic sarcoma of chest wall. Morphological, ultrastructural, immunologic, and cytogenetic study.

A case of granulocytic sarcoma presenting as a soft-tissue tumor in the chest wall in a patient with osteomyelosclerosis is reported. The tumor mass was detected by a computed tomographic scan during an investigation of the cause of chest pain in a 58-year-old man. Biopsy of the mass showed findings compatible with either a large-cell lymphoma or a granulocytic sarcoma. The latter was confirmed by naphthol-ASD-chloracetate esterase stain and electron microscopic examination. Immunologic study of the tumor mass showed expressions of membrane/cytoplasmic CD 13 and CD 15 antigens. In addition, the tumor cells coexpressed CD 19, although all other T- and B-cell-associated antigens were absent. Cytogenetic study showed translocation t(1;7)(q11;q11) with a net deletion of the entire long arm of chromosome 7 and duplication of the long arm of chromosome 1. Peripheral blood examination showed typical leukoerythroblastosis with teardrop poikilocytosis, large hypogranular platelets, and 0.11 myeloblasts. A bilateral iliac bone marrow biopsy at this time showed osteomyelosclerosis. The patient was treated with hydroxyurea followed by local irradiation, resulting in marked reduction in the size of the tumor and in the pain. He was asymptomatic without any progression in hematologic parameters 10 months after the initial diagnosis.