Microglandular Hyperplasia of the Uterine Cervix in a Patient with Breast Cancer Treated with Toremifene

Abstract

Selective estrogen receptor modulators (SERMs) have been used to treat patients with estrogen receptor-positive breast cancer. One SERM, toremifene (TOR), has been associated with increased risk of endometrial cancer, polyps, and other complications. Herein, we present a case of microglandular hyperplasia (MGH) of the uterine cervix in a breast cancer patient who had been treated with TOR for 4 years. An 81-year-old woman exhibited an enlarged uterus on CT examination and transvaginal ultrasonography revealed endometrial thickening. Cervical and endometrial cytology showed no malignant cells. MGH was present in the endometrial biopsy specimen. Six months after discontinuation of TOR, MRI showed that the endometrial thickening persisted. Therefore, we could not rule out existing malignant endometrial lesions. Hysterectomy was performed and the pathological findings included endometrial cystic changes and MGH of the cervix with no malignancy. While we did not find any malignant cells, patients with endometrial thickening should be monitored even when the cytology is negative.