title: Positron emission tomography imaging of oestrogen receptor-expression in endometrial stromal sarcoma supports oestrogen receptor-targeted therapy: case report and review of the literature.
abstract: Although the majority of endometrial stromal sarcomas (ESSs) express oestrogen receptor (ER), data on the efficacy of ER-targeted therapies are scarce. Using PubMed search engine we identified nine case reports and small series in a total of 25 patients reporting on the efficacy of palliative ER-targeted therapies. Literature supports the efficacy of aromatase inhibitors after the failure of progestins, but not of the partial ER-antagonist tamoxifen. Fulvestrant is a pure ER-antagonist with a distinct mechanism, of which efficacy has not yet been reported in ESS. We present a patient that underwent positron emission tomography and computed tomography (PET/CT) of ER-expression with the tracer (18)F-fluoroestradiol (FES). High levels of ER-expression provided a rationale for fulvestrant therapy. FES-PET/CT was repeated after 6 months and indicated a strong decrease in tumour FES-uptake, and 15% reduction in tumour diameters according to Response Evaluation Criteria in Solid Tumours (RECIST) criteria.
authors.affiliation: Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Michel
authors.initials: M
authors.lastname: van Kruchten
authors.forename: Geke A P
authors.initials: GA
authors.lastname: Hospers
authors.forename: Andor W J M
authors.initials: AW
authors.lastname: Glaudemans
authors.forename: Harry
authors.initials: H
authors.lastname: Hollema
authors.forename: Henriëtte J G
authors.initials: HJ
authors.lastname: Arts
authors.forename: Anna K L
authors.initials: AK
authors.lastname: Reyners
mesh_terms: D000328:Adult; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000378:metabolism*; D004958:Estradiol / Q000031:analogs & derivatives / Q000627:therapeutic use; D004965:Estrogen Antagonists / Q000627:therapeutic use; D005260:Female; D000077267:Fulvestrant; D006801:Humans; D049268:Positron-Emission Tomography / Q000379:methods*; D011960:Receptors, Estrogen / Q000037:antagonists & inhibitors / Q000378:metabolism*; D018203:Sarcoma, Endometrial Stromal / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000378:metabolism*; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden / Q000187:drug effects
chemical_list: D004965:Estrogen Antagonists; D011960:Receptors, Estrogen; D000077267:Fulvestrant; D004958:Estradiol
keywords: Endocrine therapy; Endometrial stromal sarcoma; FES PET; Fulvestrant; Oestrogen receptor