The reversible behavior of locally invasive endometrial carcinoma in a chromosomally mosaic (45,x/46,xr(x)) young woman treated with clomid®

Moukhtar, M; Aleem, Fatma A.; Hung, Hin Cheung; Sommers, Sheldon C.; Klinger, H.P.; Romney, Seymour L.

doi:10.1002/1097-0142(197712)40:6<2957::aid-cncr2820400631>3.0.co;2-m

Cited by 13 publications

(3 citation statements)

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“…Response rates of 20 to 35% have been reported with progestagens (Kelly & Baker 1961; Kistner et al 1965), and sustained remission with long term survival has occasionally been obtained with progesterone therapy in advanced and recurrent endometrial cancer (Aalders et al 1984). Progestagens alone also have been used successfully as primary treatment of early stage endometrial cancer in young women (Moukhtar et al 1977; Bokhman et al 1985; Thornton et al 1985; Farhi et al 1986; Lee & Scully 1989), and some women treated in this way have had successful pregnancies (O'Neill 1970; Eddy 1978; Farhi et al 1986). Although some reports have not used stringent criteria of stromal invasion, or the histologic findings have not been illustrated, there are a few well described cases cured with progestagen therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Long term follow up of those who were free of disease when the reports relating to them were published has been limited. Following initial success, various degrees of hyperplasia or reappearance of carcinoma have been observed during follow‐up (Fechner & Kaufman 1974; Moukhtar et al 1977; Lee & Scully 1989). Elective hysterectomy after completion of reproductive ambition should be considered to avoid a long stressful follow up and possible morbidity or mortality due to a delay in detecting recurrence.…”

Section: Discussionmentioning

confidence: 99%

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Successful pregnancy after tamoxifen and megestrol acetate therapy for endometrial carcinoma

Lai

Hsueh

Chad

et al. 1994

BJOG

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Case reportA 31 year old woman presented in August 1991, and her main complaint was of primary infertility and menorrhagia which she had had for two years. Her basal body temperature record showed an anovulatory pattern. She was of average stature and did not appear malnourished.No hirsutism was noted. Hormone profiles including plasma oestradiol, testosterone, prolactin, follicle stimulating hormone, luteinising hormone, diurnal cortisol and thyroid function tests were normal. Hysterosalpingography showed filling defects in the endometrial cavity and confirmed bilateral tuba1 patency. A hysteroscopic examination was performed, anticipating demonstration of a submucosal leiomyoma or endometrial polyp. Multiple endometrial polypoid masses were biopsied via the hysteroscope, followed by endometrial curettage. The histology report identified a welldifferentiated adenocarcinoma of the endometrium (Fig. 1). Fig. 1. A well differentiated adenocarcinoma. Stromal invasion is evident with the presence of confluent, cribriform glands with little or no intervening stroma. Other areas (not illustrated) showed squamous metaplasia and stromal fibrosis. (H 8c E, x 120).A fractional dilatation and curettage and cervical biopsy were carried out to collect specimens for progesterone and oestrogen receptor assay and also to confirm that there was no extension of tumour to the cervix. Both the receptor assays were positive (oestrogen receptor = 68.3 fmol/mg protein ; progesterone receptor = 99.8 fmol/mg protein). Flow cytometric DNA analysis of the tumour also was performed and revealed diploidy with low proliferative activity (%S = 3.1, %G2M = 5.9). Subsequent investigations, including a chest X-ray, complete blood count and biochemistry, blood sugar, and tumour marker (CA-125, CEA, P-hCG, and AFP) levels were normal. Duplex vaginal sonography showed normal adnexa and a residual endometrial lesion without myometrial invasion with absence of Doppler flow signal and high resistance indices of the uterine arteries. Pelvic and abdominal computerised tomography (CT) scan showed nonenlarged lymph nodes and normal intra-abdominal and pelvic organs, except for an enlarged uterus with an intrauterine lesion.The risks and potential benefits of primary hormone therapy, instead of a standard extirpative surgical approach, were discussed with the patient and she chose hormone therapy. Treatment with tamoxifen (30 mg) and megestrol acetate (160 mg) daily was given.Magnetic resonance imaging (MRI) was not available in our hospital when the treatment began, but when it became available two months later the woman had a negative MRI examination with a thin regular endometrium and intact junctional zone. At two months after hormone therapy began she had a fractional dilatation and curettage which did not identify any residual malignancy (Fig. 2).She continued on hormone therapy and had serial monitoring studies, including sonography, CT or MRI scans, and tumour markers. Four months after treatment began, repeat hysteroscopy and endometrial curettage ...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Successful pregnancy after tamoxifen and megestrol acetate therapy for endometrial carcinoma

Lai

Hsueh

Chad

et al. 1994

BJOG

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“…Women younger than 40 years of age may account for 3%-14% of all cases of endometrial cancer [32][33][34][35]. Endometrial cancer has also been diagnosed, albeit rarely, in women younger than 25 years old and even as young as 15 [38][39][40][41]. Young patients who develop endometrial cancer often have some degree of hyperestrogenism, anovulation, obesity, and lipid and carbohydrate imbalance.…”

Section: Endometrial Cancermentioning

confidence: 99%

Fertility‐Sparing Options for Patients with Gynecologic Malignancies

Leitao¹,

Dennis

2005

The Oncologist

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Learning ObjectivesAfter completing this course, the reader will be able to:1. Describe the options available for women with gynecologic malignancies that will allow the preservation of fertility.2. Identify women with gynerologic malignancies who might be eligible for fertility-sparing alternatives.3. Discuss the limited data supporting these novel fertility-sparing options. AbstractGynecologic malignancies are most often diagnosed in postmenopausal women, but these malignancies also arise in premenopausal women, in whom issues of fertility can be a major concern. An increasing number of women are delaying childbearing. This has led to a significant increase in the number of women diagnosed with a gynecologic malignancy before desired completion of childbearing. Many of the standard treatments for these malignancies result in permanent sterility; however, there are now options for select young women who desire to preserve fertility. Patients should be told that data on fertility-sparing procedures are limited and that many of these options are of an experimental, nonstandard nature. The care of these patients is challenging and complex and requires a multidisciplinary approach, which should include gynecologic oncologists, reproductive endocrinologists, and perinatologists. The Oncologist 2005;10:613-622

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