What history does this incidental finding suggest?

August 14, 2018

Figure 1 Quiz of the Week

A 62-year-old female, G3P3, presents to her gynecologist with a year-long history of worsening stress urinary incontinence. During the course of her investigation, a pelvic MRI is performed, and reveals the findings seen here.

Which of the following histories is most consistent with these findings?

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Image credit: @WAiKtheRAD.


Answer: Breast cancer

The thickening and cystic changes of the endometrium seen here are associated with the use of tamoxifen, a nonsteroidal selective estrogen receptor modulator used primarily to treat estrogen receptor-positive breast cancer. While tamoxifen’s primary therapeutic effect is derived from its antiestrogenic properties, it also has modest estrogenic activity that can result in endometrial proliferation. Its use is associated with both benign and malignant uterine pathology, such as endometrial polyps, endometrial carcinoma, and uterine sarcoma.

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