Abstract
Tamoxifen is widely used as adjunctive therapy for patients with breast cancer and
has been suggested as protection against the development of breast cancer in women
at risk on the basis of heredity. It is a nonsteroidal estrogen antagonist, but like
all antagonists it has some agonistic properties. Its administration should result
in atrophic changes in the endometrium, but paradoxically some reports have found
hyperplasia and even carcinomas developing prospectively in patients on tamoxifen
therapy. Increasingly, endovaginal ultrasonography is being used for endometrial assessment
in a wide variety of patients. This report is the first description of an unusual
ultrasonographic finding in the uteri of some patients receiving tamoxifen. Initially
believed to be endometrial in location, when viewed after fluid instillation (sonohysterogram)
the heterogenous bizarre ultrasonographic appearance was actually found to represent
small subendometrial sonolucencies in the proximal myometrium. Because none of these
patients were clinically bleeding and all had inactive endometria on biopsy, it seems
prudent not to overinterpret ultrasonography findings in patients receiving tamoxifen
who have not had fluid-enhanced assessment. (AM J OBSTET GYNECOL 1994;170:447-51.)
Keywords
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Article Info
Footnotes
*From New York University of Medicine, Department of Obstetrics and Gynecology.
**Reprint requests: Steven R. Goldstein, MD, 530 First Ave., New York, NY 10016.
*0002-9378/94 $3.00 + 0 6/1/50665
Identification
Copyright
© 1994 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
