Tamoxifen-associated polypoid endometriosis mimicking an ovarian neoplasm

In Ho Choi, So-Young Jin, Yoon Mi Jeen, Jeong Jae Lee, Dong Won Kim
Obstetrics & gynecology science · 2015 · vol. 58(4) , pp. 327 · doi:10.5468/ogs.2015.58.4.327 · PMID:26217606 · PMC4515485 · W2249802888
article OA: gold CC0 ⤵ 12 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This case study describes a postmenopausal woman on tamoxifen treatment who developed polypoid endometriosis mimicking an ovarian neoplasm, a rare complication confirmed by surgical and immunohistochemical analysis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This paper reports a case of tamoxifen-associated polypoid endometriosis in a 66-year-old postmenopausal woman with a history of breast cancer treated with tamoxifen, who was evaluated for an incidentally detected ovarian cyst and suspected endometrial hyperplasia based on ultrasound and MRI. Imaging suggested a ~4.1×3.4 cm multicystic right adnexal mass with concurrent endometrial thickening; she underwent hysterectomy with bilateral salpingo-oophorectomy, and pathology identified a right paratubal polypoid lesion composed of cystically dilated endometrial glands and stroma, with CD10-positive stromal cells and no glandular atypia or malignancy. The authors note that polypoid endometriosis is rare and can mimic malignant neoplasms, making histologic and immunohistochemical differentiation important, but the primary limitation is that this is a single case report without broader generalizability. This paper is centrally about endometriosis — specifically tamoxifen-associated polypoid endometriosis presenting as an ovarian/paratubal mass that mimicked an ovarian neoplasm.

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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 4.1×3.4-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.

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endometriosis

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