title: Malignant mixed mesodermal tumor after tamoxifen therapy for breast cancer.
abstract: BACKGROUND
  The risk of tamoxifen related endometrial neoplasm has been confirmed by multiple studies. Especially rare endometrial tumors seem to develop more frequently under tamoxifen therapy. A recent analysis showed a substantially higher risk for malignant mixed mesodermal tumor (MMMT; designated in the WHO classification of female genital tract neoplasms as carcinosarcoma) in association with tamoxifen intake.
  
  
  METHODS
  We are reporting a case of a 40-year-old multiparous premenopausal woman who received tamoxifen 20 mg daily for 2 years after the surgical treatment of breast cancer and subsequent adjuvant chemotherapy. Two years after initiation of tamoxifen treatment, the patient developed an MMMT of the uterus. More than 64 months after radical hysterectomy, salpingo-oophorectomy, and pelvic lymphadenectomy, she remains recurrence-free for MMMT. Unfortunately, she developed a local recurrence of her breast cancer in 2003. After surgical treatment, she is currently being treated with anastrozole.
  
  
  CONCLUSIONS
  We are reporting a rare case of a premenopausal patient who developed a MMMT within short time of tamoxifen exposure for stage I breast cancer.
authors.affiliation: Department of Obstetrics and Gynecology, Innsbruck Medical University, A-6020 Innsbruck, Austria. Michael.Hubalek@uibk.ac.at
authors.forename: Michael
authors.initials: M
authors.lastname: Hubalek
authors.forename: Angela
authors.initials: A
authors.lastname: Ramoni
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Mueller-Holzner
authors.forename: Christian
authors.initials: C
authors.lastname: Marth
mesh_terms: D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D018199:Mixed Tumor, Mesodermal / Q000139:chemically induced*; D016609:Neoplasms, Second Primary / Q000139:chemically induced*; D013629:Tamoxifen / Q000009:adverse effects* / Q000627:therapeutic use; D014594:Uterine Neoplasms / Q000139:chemically induced*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen