Tamoxifen induced adenomyosis and adenomyomatous endometrial polyp

Ugwumadu, Austin; Bower, David; Ho, Philip Kin-Hoi

doi:10.1111/j.1471-0528.1993.tb12986.x

Cited by 36 publications

(30 citation statements)

References 20 publications

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“…These ectopic endometriotic foci are more or less autonomous [24] and may have different hormonal sensitivity levels than the normal endometrium [25][26][27]. Endometriosis [5,6,8,9,28] as well as adenomyosis [3,6,11] have been reported to possibly develop in postmenopausal breast cancer patients on TAM treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Extrauterine ectopic endometrial tissue is potentially subject to some of the same influences that affect the intrauterine endometrium [3][4][5][6][7][8][9][10][11]. It is similarly influenced by ovarian or extraovarian estrogens [22,23].…”

Section: Discussionmentioning

confidence: 99%

“…It has been found to be associated with the induction of adenomyosis in postmenopausal breast cancer patients on TAM treatment [3,6,11].…”

Section: Introductionmentioning

confidence: 99%

“…It is well established that this pathologic entity is affected by estrogen stimulation [2], and thus is potentially subject to hormonal treatment that affects the endometrium [3][4][5][6][7][8][9][10][11], especially in postmenopausal women [7,10,11].…”

Section: Introductionmentioning

confidence: 99%

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Estrogen and Progesterone Receptors of Adenomyosis in Postmenopausal Breast Cancer Patients Treated with Tamoxifen

Cohen¹,

Shapira²,

Beyth³

et al. 1998

Gynecol Obstet Invest

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Adenomyosis is an ectopic endometrial tissue located in the myometrium. It has been reported to develop at a higher rate among postmenopausal breast cancer patients on tamoxifen (TAM) treatment than in untreated patients. It has also been reported to be stimulated by estrogen. Assessing receptor levels in adenomyotic tissue may indicate the adenomyotic cell’s potential to interact with TAM. In the present study the estrogen receptor (ER) and progesterone receptor (PR) were analyzed by an immunohistochemical technique in adenomyotic and the corresponding endometrial tissues of 14 postmenopausal breast cancer patients treated with TAM and in 15 healthy postmenopausal patients who served as controls. All TAM-treated patients had normal postmenopausal serum estradiol levels. Overall the ER and PR contents in adenomyotic tissue (42.9 and 71.4%) and in the endometriotic tissue (64.3 and 78.6%) obtained from the study patients were similar to those obtained from the control group (adenomyosis, ER and PR = 46.7 and 86.7%; endometrium, ER and PR = 40 and 73.3%; p = NS). In the study group, the ER content was lower in the adenomyotic (42.9%) than in the endometriotic tissue (64.3%). No correlation was found between the duration of TAM therapy, the TAM dosage level or the ER or PR content in the adenomyotic or endometrial tissues. The finding of a relatively low ER content in the adenomyotic tissue than in the endometriotic tissue in postmenopausal TAM-treated patients without endogenous estrogens, similar to that observed in healthy premenopausal women, may be attributed to the estrogen-like effect of TAM.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…It has been found to be associated with the induction of adenomyosis in postmenopausal breast cancer patients on TAM treatment [3,6,11].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Estrogen and Progesterone Receptors of Adenomyosis in Postmenopausal Breast Cancer Patients Treated with Tamoxifen

Cohen¹,

Shapira²,

Beyth³

et al. 1998

Gynecol Obstet Invest

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“…Neither the glandular epithelium nor the stromal cells exhibited atypia'. Three of the cases described were found in older patients treated with tamoxifen [53,54,55]. Their description is strikingly similar to that made by Rokitansky; in addition, an imaging review of adenomyosis features by Tamai et al [56] considered adenomatous polyps a variant of adenomyosis: ‘Less commonly, adenomyosis can present as a well-circumscribed form known as adenomyoma, adenomyotic cyst characterized by the presence of haemorrhagic cyst, or adenomyomatous polyp protruding into the uterine cavity.'…”

Section: The Identification Of Adenomyomamentioning

confidence: 99%

The History of Endometriosis

Benagiano

Brosens

Lippi

2014

Gynecol Obstet Invest

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A dispute has recently emerged whether early descriptions exist of the condition we name endometriosis. A first question is: ‘Who identified endometriosis?' To respond, two non-complementary methods have been employed: searching for ancient descriptions of symptoms associated with endometriosis or, alternatively, identifying researchers who described pathological features we associate with the presence of endometriosis in its various forms. We opted for the latter and found no evidence that in older times anyone delineated the macroscopic features of endometriosis; descriptions of menstrual or cyclic pain cannot be taken as proof of knowledge of what caused it. During the mid-part of the 19th century, Rokitansky had a great intuition: endometrial glands and stroma can be present in ovarian and uterine neoplasias. However, using histological parameters of endometrial structure and activity, the first scientist to delineate peritoneal endometriosis under the name ‘adenomyoma' was Cullen. On the other hand, Rokitansky was the first to describe a form of adenomyosis (an adenomatous polyp). Early descriptions of ovarian endometrioma as ‘haematomas of the ovary' or ‘chocolate cysts' date back to the end of the 19th century. The first mention of an ‘ovary containing uterine mucosa' was published in 1899 by Russel, but Sampson was the first to demonstrate specific endometrial activities, such as desquamation at the time of menstruation and decidualization in pregnancy; subsequently, he presented a theory on its pathogenesis.

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Small cells in cervical-vaginal smears of patients treated with tamoxifen

Opjorden

Caudill

Humphrey

et al. 2001

Cancer

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BACKGROUND “Small cells” have been described in the cervical‐vaginal (Papanicolaou [Pap]) smears of patients receiving tamoxifen. The current study determined the frequency of this finding and its implications for the differential diagnosis. METHODS A computer‐based search of the cytopathology files from January 1994 to December 1998 was performed for Pap smears from patients with a history of tamoxifen treatment. All smears were reviewed for the presence of “small cells” and endometrial cells. Pap smears from an age‐matched control group that was not treated with tamoxifen also were screened for “small cells.” RESULTS Five hundred forty‐eight Pap smears were identified from 425 patients (mean age, 62 years; average duration of treatment, 43 months). Clusters of these “small cells” were present in 104 Pap smears from 86 patients (19%). The background pattern was proliferative in the majority of the Pap smears (83%). In five Pap smears (5%), these “small cells” were interpreted originally as endometrial cells. In the remaining Pap smears, no reference to the presence of the cells was made in the original report. “Small cells” were identified in 79 Pap smears (18%) in the control group (n = 443 smears). CONCLUSIONS The incidence of “small cells” is similar in the Pap smears of patients with or without a history of tamoxifen treatment. These cells are similar to reserve cells noted in atrophic smears. However, as a result of the proliferative effect of tamoxifen in the cervical epithelium, these cells are prominent when admixed with superficial and intermediate cells in patients treated with tamoxifen. These cells need to be differentiated from endometrial cells to avoid unnecessary follow‐up procedures. Cancer (Cancer Cytopathol) 2001;93:23–28. © 2001 American Cancer Society.

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Tamoxifen induced adenomyosis and adenomyomatous endometrial polyp

Cited by 36 publications

References 20 publications

Estrogen and Progesterone Receptors of Adenomyosis in Postmenopausal Breast Cancer Patients Treated with Tamoxifen

Estrogen and Progesterone Receptors of Adenomyosis in Postmenopausal Breast Cancer Patients Treated with Tamoxifen

The History of Endometriosis

Small cells in cervical-vaginal smears of patients treated with tamoxifen

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