RESUMO
It is well known that a large number of patients treated with Tamoxifen develops endometrial pathologies ranging from benign endometrial polyps and hyperplasia to adenocarcinomas, carcinosarcomas and adenosarcomas. UTROSCT (Uterine Tumor Resembling Ovarian Sex Cord Tumor) is defined as a mesenchymal tumors of the uterine corpus that morphologically resembles ovarian sex cord tumors, without recognizable endometrial stroma. To date only 4 cases have been reported in patients treated with tamoxifen. In this article, we describe an additional case occurring in a 62-years-old patient undergoing 3 years of Tamoxifen therapy for bilateral breast carcinoma. The present work represents a further evidence of the possible association between Tamoxifen therapy and UTROSCT. A comprehensive literature review on this topic is also provided.
Assuntos
Moduladores Seletivos de Receptor Estrogênico/efeitos adversos , Tumores do Estroma Gonadal e dos Cordões Sexuais/induzido quimicamente , Tamoxifeno/efeitos adversos , Neoplasias Uterinas/induzido quimicamente , Neoplasias da Mama/tratamento farmacológico , Carcinoma Ductal de Mama/tratamento farmacológico , Comorbidade , Feminino , Humanos , Leiomioma/epidemiologia , Leiomioma/cirurgia , Pessoa de Meia-IdadeRESUMO
Increasing number of uterine malignancies have been reported in breast cancer patients using tamoxifen. Most of these are endometrial adenocarcinomas. However, only a few cases of endometrial stromal sarcomas have been reported to be linked with tamoxifen usage. A 58-year-old postmenopausal women who had been using tamoxifen for 4 years after a surgery for breast cancer is presented with chronic pelvic pain. Preoperative investigations were indicative of a uterine myoma so that a standard total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. Postoperative histologic diagnosis was a uterine tumor resembling ovarian sex cord tumors, which is an exceedingly rare entity itself. The present case is the first designated diagnosis of this rare tumor, with a possible association of tamoxifen usage.
Assuntos
Antineoplásicos Hormonais/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Tumores do Estroma Gonadal e dos Cordões Sexuais/diagnóstico , Tamoxifeno/efeitos adversos , Neoplasias Uterinas/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Histerectomia , Pessoa de Meia-Idade , Ovariectomia , Pós-Menopausa , Tumores do Estroma Gonadal e dos Cordões Sexuais/induzido quimicamente , Tumores do Estroma Gonadal e dos Cordões Sexuais/cirurgia , Neoplasias Uterinas/induzido quimicamente , Neoplasias Uterinas/cirurgiaRESUMO
Low-grade endometrial stromal sarcoma with sex cord-like differentiation occurred in two postmenopausal patients who had received tamoxifen for more than 3 years after surgical resection for breast cancer. Uterine sarcomas have been described in association with the use of tamoxifen. Only two cases of endometrial stromal sarcoma with sex cord-like features associated with tamoxifen use have been reported previously. This report adds an additional two cases of this tumor. Immunohistochemical and ultrastructural examinations of the tumor support the concept of smooth muscle differentiation in the sex cord-like areas. This observation proposes that the low-grade endometrial stromal sarcoma with sex cord-like elements may be a consequence of tamoxifen ingestion, but the exact mechanism of tamoxifen in the development of this tumor remains speculative.
