Abstract
A very rare case of homologous carcinosarcoma of the endometrium associated with long-term tamoxifen treatment for breast cancer is reported. A 70-year-old Japanese woman was admitted with atypical genital bleeding. Six years earlier, she had undergone total right mastectomy for breast cancer, and administration of tamoxifen had been started postoperatively. On admission, biopsy revealed a homologous carcinosarcoma of the endometrium with metastasis in the endocervix. The patient underwent a Wertheim's hysterectomy that revealed stage IIIc disease with pelvic lymph node metastasis. She received six courses of adjuvant chemotherapy. Histological examination showed a homologous carcinosarcoma, composed of poorly differentiated adenocarcinoma and anaplastic sarcoma. No heterologous elements; for example, malignant cartilage or rhabdomyoblasts, were seen. Tamoxifen is a possible etiologic factor in the development of endometrial carcinosarcomas.
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