Endometrial mesodermal mixed tumor occurring after tamoxifen treatment: Report on a new case and review of the literature

Background: Anti oestrogenic treatment is widely used for breast cancer tre atment and prevention of recurrence. Because of concomitant estrogenic effe cts, tamoxifen exerts carcinogenic properties on the endometrium. Although secondary endometrial cancers usually present as pure adenocarcinomas, othe r types of rare tumors have also been reported. Patients and methods: Herein we describe the clinical, pathological as well as therapeutic aspects of a new case of endometrial mesodermal mixed tumor occurring after long-term tamoxifen therapy. Results: The present case occured five years after cessation of a five year s tamoxifen treatment. The patient failed to respond to doxorubicin and cyc lophosphamide when combined to 5-fluorouracil (5-FU), but she reached compl ete response when the same two drugs were used with carboplatin, suggesting the potential usefullness of platinum derivatives. Conclusions: A longer latency period might be observed for endometrial meso dermal mixed tumors as compared to adenocarcinomas and could justify a prol onged clinical and ultrasonographic follow-up of patients during and after tamoxifen treatment. When indicated, chemotherapy might require the use of platinum derivatives in this particular type of secondary tumor.