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Publication
Efeitos ginecológicos do "tamoxifeno": contributo da radiologia
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Advisor(s)
Abstract(s)
O “Tamoxifeno” (TAM) é a terapêutica anti-estrogénica de escolha nas doentes com cancro da mama. Os efeitos proliferativos do
TAM em idade pós-menopausa têm sido associados a hiperplasia, pólipos, carcinoma e sarcoma do endométrio. As doentes
tratadas com TAM têm também maior incidência de leiomiomas, adenomiose e endometriose, assim como maior risco de quistos
do ovário. O método de primeira linha na vigilância das mulheres sob TAM é a ecografia transvaginal (US-TV). O endométrio
apresenta-se frequentemente espessado e com áreas quísticas, aspectos passíveis de melhor caracterização por histerossonografia
e ressonância magnética. Nas imagens ponderadas em T2, um endométrio espessado e heterogéneo com captação de aspecto
reticulado e a opacificação da interface endométrio-miométrio associam-se a lesões de pior prognóstico (pólipos, hiperplasia
atípica e neoplasia). O conhecimento dos efeitos ginecológicos do TAM e da sua tradução radiológica promove o diagnóstico
precoce e adequado encaminhamento destas doentes.
“Tamoxifen” (TAM) is the anti-estrogenic treatment of choice for breast cancer patients. The proliferative effects of postmenopausal TAM have been associated with endometrial hyperplasia, polyps, endometrial carcinoma and endometrial sarcoma. TAM treated patients also have higher incidence of leiomyomas, adenomyosis and endometriosis, as increased risk of ovarian cysts. Transvaginal ultrasound (TVS) is the first line imaging modality in the surveillance of women treated with TAM. The commonest endometrial pattern is thickening with cystic areas, features that can be better characterized by hysterosonography or magnetic resonance. On T2-WI thickened and heterogeneous endometrium with lattice-like enhancement, as the enhancement of the endometrial-miometrial interface have been associated with worse prognosis (polyps, atypical hyperplasia, cancer). The knowledge of the gynecological effects of TAM and their imaging features promotes early diagnosis and adequate orientation of these patients.
“Tamoxifen” (TAM) is the anti-estrogenic treatment of choice for breast cancer patients. The proliferative effects of postmenopausal TAM have been associated with endometrial hyperplasia, polyps, endometrial carcinoma and endometrial sarcoma. TAM treated patients also have higher incidence of leiomyomas, adenomyosis and endometriosis, as increased risk of ovarian cysts. Transvaginal ultrasound (TVS) is the first line imaging modality in the surveillance of women treated with TAM. The commonest endometrial pattern is thickening with cystic areas, features that can be better characterized by hysterosonography or magnetic resonance. On T2-WI thickened and heterogeneous endometrium with lattice-like enhancement, as the enhancement of the endometrial-miometrial interface have been associated with worse prognosis (polyps, atypical hyperplasia, cancer). The knowledge of the gynecological effects of TAM and their imaging features promotes early diagnosis and adequate orientation of these patients.
Description
Keywords
Tamoxifeno Pólipo endometrial Carcinoma endometrial Adenomiose Tamoxifen Endometrial polyp Endometrial carcinoma Adenomyosis
Citation
Dulce Antunes; Teresa Margarida Cunha. Tamoxifen Gynecological Side Effects: The Role of Imaging, Acta Radiológica Portuguesa, 24, 95, 41-46, 2012.