Tamoxifen and growth of an extrauterine leiomyoma

Bayya, Jyothshna; Minkoff, Howard; Khulpateea, Neekianund

doi:10.1016/j.ejogrb.2008.07.001

Cited by 10 publications

(5 citation statements)

References 2 publications

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“…Some case reports indicate that Tamoxifen provided symptomatic relief for BML patients, but very rarely did treatment cause regression of tumor nodules (23,30). (Table 1) The reports of unsuccessful results with Tamoxifen therapy can be attributed to its estrogen agonism on the myometrium (31), with one case report demonstrating the ability of Tamoxifen to promote extrauterine leiomyoma growth (32). Raloxifene, another SERM, which has a known estrogenic antagonist effect on the breast and uterus, has shown greater success in treatment of BML (33).…”

Section: Discussionmentioning

confidence: 99%

Novel hormone treatment of benign metastasizing leiomyoma: an analysis of five cases and literature review

Lewis

Chason

DeCherney

et al. 2013

Fertility and Sterility

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Objective To evaluate novel hormonal therapies in patients with unresectable Benign Metastasizing Leiomyoma (BML) disease. Design Case series. Setting National Institutes of Health (NIH). Patients 5 subjects with the diagnosis of BML based on imaging and/or histopathologic diagnosis. Interventions Four patients were treated with single or combination therapy of Leuprolide acetate and/or an aromatase inhibitor. One patient was treated with an antiprogestin (CDB-2914). Main Outcome Measures Response to therapy was measured by tumor burden on cross-sectional imaging employing RECIST (Response Evaluation Criteria in Solid Tumours) 1.1 guidelines. Results Four patients treated with single or combination therapy of Leuprolide acetate and/or an aromatase inhibitor demonstrated stable disease with reduction in tumor burden. The fifth patient treated with antiprogestin (CDB-2914) had degeneration of her tumor, progression of its size and an improvement in symptoms. Conclusions Hormonal treatment with GnRH agonism and/or aromatase inhibition may be a therapeutic option to reduce tumor burden in unresectable BML disease or for those patients who wish to avoid surgical intervention. RECIST 1.1 guidelines, while traditionally used to evaluate tumor response to cancer therapeutics, may be useful in evaluating BML tumor burden response to hormonal therapy.

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Section: Discussionmentioning

confidence: 99%

Novel hormone treatment of benign metastasizing leiomyoma: an analysis of five cases and literature review

Lewis

Chason

DeCherney

et al. 2013

Fertility and Sterility

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“…Tamoxifen, on the other hand, seems to have a deleterious effect by promoting uterine estrogen agonism, and even promoting the growth of metastasizing leiomyomata. 81 , 91 A review by Lewis et al 78 revealed a negative or nonbeneficial impact of tamoxifen in the majority of cases of BML treated with tamoxifen.…”

Section: Discussionmentioning

confidence: 99%

“…Direct hormonal blockade with progesterone has also been tried, but apparently with varying results. 81 Progesterone suppresses the hypothalamic–pituitary–gonadal axis and hampers the production of estrogen by the ovaries. Moreover, progesterone also increases conversion of estradiol to estrone in endometrial tissue 82 and decreases intracellular aromatase activity by up to 30%.…”

Section: Discussionmentioning

confidence: 99%

“… 10 , 11 In the case of LPD, follow-up is especially important in the first year due to a higher risk of degenerescence into leiomyosarcoma. 6 , 38 , 81 , 89 This transformation seems to occur more often in patients without an evident hormonal terrain (eg, without a previous history of fibroma or with a hormone receptor non-expressing tumor), for whom hormone therapy might be less effective. 46 In the case of HLRCC syndrome, given that 6.7% of renal cell carcinoma cases appear before the age of 20, and that the youngest case known is that of a 10-year-old infant, assessments should be started by the age of 8-10, including the search for mutations.…”

Section: Discussionmentioning

confidence: 99%

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Benign Metastasizing Leiomyomatosis to the Skin and Lungs, Intravenous Leiomyomatosis, and Leiomyomatosis Peritonealis Disseminata: A Series of Five Cases

Ferreira

Cabrera²,

Santos³

et al. 2022

The Oncologist

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Benign metastasizing leiomyomatosis (BML) is a rare disease that typically occurs in women with a history of uterine leiomyomatosis. Benign metastasizing leiomyomatosis occurs more frequently in the lungs but may also develop in other organs and tissues. Other unusual variants of extra-uterine leiomyomatosis include intravenous leiomyomatosis (IVL) and leiomyomatosis peritonealis disseminata (LPD). In this article, three cases of BML are presented. One case, in a premenopausal woman, presented cutaneous metastases. We also present a case of IVL and a case of LPD, which occurred in postmenopausal women. Given the rarity of BML, IVL, and LPD, the authors reviewed the literature and herein discuss the implications for treatment in all five cases. Evidence for treating BML, IVL, and LPD is still scarce, and data available from our series and other small series seem to point to the patient’s hormonal status playing a fundamental part in the treatment plan. Furthermore, a collecting bag when performing excision of uterine leiomyomas may help avoid the potential spreading of leiomyomatosis. Hysterectomized patients with chronic cough, frequent respiratory infections, abdominal discomfort, right heart failure, or non-specific symptoms should be actively screened for BML, IVL, and LPD. Treatment should be individualized according to each patient’s hormonal status and desires.

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“…Some study recommend the use hormonal therapy, especially if the patient is premenopausal, in case of recurrence or in order to reduce the tumor size if the patient reclines surgery [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , but the side effects of premature menopause have to be balanced with the eventual benefices of this medication [58] . A case with increase of tumor burden was described after Tamoxifen treatment emphasizing the necessity to consider carefully the indication of hormonal therapy [59] . Radiotherapy at low doses is described in patients at high risk of recurrence [60] .…”

Section: Discussionmentioning

confidence: 99%

Intravenous leiomyomatosis: Case series and review of the literature

Mathey

Huber

2021

International Journal of Surgery Case Reports

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Introduction Intravenous leiomyomatosis (ILV) is a rare pathology, part of leiomyoma beyond the uterus (LBU), characterized by benign smooth muscle cell tumor outside of the uterus and mainly affecting premenopausal woman with a medical history of leiomyoma or gynecologic surgical treatment. The treatment depends on the localization of the tumor, age of the patient, initial size, symptoms and the suitability for surgery but should always aims in toto surgical resection. Case presentation Retrospective case series and review of literature. Clinical discussion Symptoms presented by the patient were aspecific and only localized in the pelvic area. All cases were fortuitous histopathological diagnosis. No relapse was. Two out of 5 patients have pulmonary nodules, only one was biopsied and diagnosed with PBML (pulmonary benign metastasizing leiomyoma). Conclusion IVL and BML are rare disease that can co-exist. Because of tumoral hormonal receptors, hormonotherapy could be an optional treatment but to date no clear efficacy is demonstrated. In case of high recurrence risk such as voluminous initial mass, impairment of broad ligament, failure of total surgical resection, adjuvant hormonotherapy could be useful. Recurrence rate is about 16.6-30% and can occur even dozen years later and even after radical surgery, justifying a regular follow up.

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Tamoxifen and growth of an extrauterine leiomyoma

Cited by 10 publications

References 2 publications

Novel hormone treatment of benign metastasizing leiomyoma: an analysis of five cases and literature review

Novel hormone treatment of benign metastasizing leiomyoma: an analysis of five cases and literature review

Benign Metastasizing Leiomyomatosis to the Skin and Lungs, Intravenous Leiomyomatosis, and Leiomyomatosis Peritonealis Disseminata: A Series of Five Cases

Intravenous leiomyomatosis: Case series and review of the literature

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