Case Report
Uterine adenofibroma and endometrial stromal sarcoma associated with tamoxifen therapy: MR findings

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Abstract

Tamoxifen therapy may result in a variety of endometrial proliferative lesions, including adenofibroma and endometrial stromal sarcoma (ESS). This report describes the MR findings of adenofibroma and ESS associated with tamoxifen therapy. When MRI demonstrates a uterine mass appearing as a heterogeneous mass in the endometrium or myometrium, adenofibroma and ECC must be considered as rare, but possible, diagnoses.

Section snippets

Case 1

A 74-year-old woman, who was postmenopausal, had been taking tamoxifen 20 mg daily for 3 years for breast cancer. She was asymptomatic, but on routine ultrasound a mass was detected in the uterus, for which she was referred for MRI examination. Routine hematological, biochemical and tumor marker determinations revealed no particular abnormalities. On pelvic examination, the uterus was slightly enlarged, while the cervix appeared normal. On sagittal T2-weighted MR images, a heterogeneously

Discussion

Tamoxifen, a nonsteroid triphenylethylene derivative that is structurally related to the synthetic estrogen diethylstilbestrol [7], is the most widely prescribed anticancer agent [8]. Paradoxically, tamoxifen acts as an estrogen agonist in the gynecological tract, including the endometrium, and is associated with an increased frequency of proliferative endometrial lesions, including endometrial neoplasm [9]. In 89 cases receiving tamoxifen therapy, uterine adenofibroma was reported in only a

Kazumasa Hayasaka is the director of Radiology department, National Center for Geriatrics and Gerontology, Japan.

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Kazumasa Hayasaka is the director of Radiology department, National Center for Geriatrics and Gerontology, Japan.

Kazuo Morita is the director of Obstetrics and Gynecology department, Akiru Municipal General Hospital, Japan.

Tomoya Saitoh is an assistant of Radiology department, Nihon University School of Medicine, Japan.

Yoshiaki Tanaka is professor of Radiology department, Nihon University School of Medicine, Japan.

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