乳癌術後のtamoxifen長期服用患者の子宮に発生したadenosarcoma with sarcomatous overgrowthの1例

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  • Adenosarcoma of a Adenosarcoma of the Uterus with Sarcomatous Overgrowth in a Patient with Long Term Tamoxifen Treatment for Breast Cancer

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We describe a case of uterine adenosarcoma with sarcomatous overgrowth in a longterm tamoxifen-treated woman with breast cancer.A 59-year-old woman, gravida 1, para 1, underwent a left radical mastectomy in May, 1981 for breast cancer.In August, 1983 she was started on tamoxifen as adjuvant therapy.She was treated with tamoxifen, 20mg daily, for 117 months and 10mg daily, for 17 months.Menses had been regular(or irregular)before she started tamoxifen, with the last menstrual period in 1992.She was diagnosed in 1992 with myoma uteri.She reported abnormal genital bleeding(spotting)for 10 days on September 19, 1996.On pelvic examination she was noted to have a fist size uterus.Smears from the cervix and endometrium showed Papanicolaou's class II.Microscopic examination of endometrial biopsies indicated a adenofibroma.Her CA125 and SLX levels were 162 U/ml and 88.5 U/ml, respectively.A total abdominal hysterectomy and bilateral salpingo-oophorectcomy were performed on September 25, 1996.The clinical diagnosis was a carcinoma of the uterine corpus, stage Ib.The pathologic findings, showed an adenosarcoma of the uterine corpus with sarcomatous overgrowth.She received 3 kurs of CyVADic therapy.The patient is currently free of disease 12 months from the time of hysterectomy.

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