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J Gynecol Oncol. 2010 Dec 30;21(4):269-72. doi: 10.3802/jgo.2010.21.4.269. Epub 2010 Dec 31.

Endometrial mullerian adenosarcoma after toremifene treatment in breast cancer patients: a case report.

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Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.


Toremifene is an anti-estrogen which has been shown to be effective in the treatment of breast cancer, and is thought to be a less uterotrophic agent than tamoxifen. The risk assessment concerning endometrial cancer has been inconclusive because of its rare use up to the mid-1990s. We report a case of an adenosarcoma, which is a very rare type of uterine malignancy, after toremifene treatment for 5 years in a breast cancer patient. After 1 year of toremifene use, the patient had a benign Mullerian adenofibroma. After an additional 4 years of toremifene treatment, the endometrial polypoid lesion was transformed into a Mullerian adenosarcoma. Although toremifene is a promising anti-estrogenic agent in the treatment of breast cancer patients, clinicians should not neglect the possibility of a uterine malignancy.


Breast cancer; Mullerian adenofibroma; Mullerian adenosarcoma; Tamoxifen; Toremifene

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