Obstet Gynecol Sci.  2015 Jul;58(4):327-330. 10.5468/ogs.2015.58.4.327.

Tamoxifen-associated polypoid endometriosis mimicking an ovarian neoplasm

• Choi IH
• Jin SY
• Jeen YM
• Lee JJ
• Kim DW

• KMID: 2314056
• DOI: http://doi.org/10.5468/ogs.2015.58.4.327

Abstract

Tamoxifen has been widely used for adjuvant treatment of breast cancer, but several gynecological side effects have been noted, including endometrial hyperplasia, polyp and carcinoma. Polypoid endometriosis is one of the extremely rare benign complications associated with tamoxifen therapy. A 66-year-old postmenopausal woman, who had received left partial mastectomy due to breast cancer (about 4 years ago) and was taking tamoxifen treatment, had an ovarian cyst on ultrasonography. Pelvic magnetic resonance imaging suggested tamoxifen-associated endometrial and ovarian changes, especially a 4.1x3.4-cm-sized, well-defined, multicystic mass in the right ovary. She received hysterectomy with bilateral salpingo-oophorectomy. Microscopically, the right paratubal mass showed endometrial glands and stroma, and immunohistochemical staining for CD10 confirmed the endometrial nature of the stroma. Three cases of polypoid endometriosis have been reported in the Korean literature, but in none of the cases, polypoid endometriosis was associated with tamoxifen use. Herein, we report the first case of polypoid endometriosis associated with tamoxifen treatment in Korea.

Keyword

Endometriosis; Polyps; Tamoxifen

MeSH Terms

Aged
Breast Neoplasms
Endometrial Hyperplasia
Endometriosis*
Female
Humans
Hysterectomy
Korea
Magnetic Resonance Imaging
Mastectomy, Segmental
Ovarian Cysts
Ovarian Neoplasms*
Ovary
Polyps
Tamoxifen
Ultrasonography
Tamoxifen

Figure

• 

  Fig. 1 (A,B) Pelvic dynamic magnetic resonance imaging shows multiple subendometrial cystic changes with mildly thickened endometrium and a 4.1×3.4-cm-sized, well-defined, multicystic lesion in the right adnexal portion.

• 

  Fig. 2 (A) An approximately 4×3-cm-sized, polypoid mass is noted in the right paratubal area. (B) At lower magnification, it appears as a multilocular cystic mass, which consists of cystically dilated endometrial glands and stroma (H&E, ×12.5). (C) The glands are lined by a single layer of columnar or cuboidal cells with no cellular atypia or mitosis (H&E, ×400). (D) The stromal cells show positivity for CD10 (CD10, ×200).

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