Tamoxifen-related uterine carcinosarcomas occur under/after prolonged treatment: report of five cases and review of the literature

Int J Gynecol Cancer. 2002 Sep-Oct;12(5):496-500. doi: 10.1046/j.1525-1438.2002.01134.x.


The risk of tamoxifen-related endometrial adenocarcinoma is well established with daily dose and treatment duration of adjuvant tamoxifen as risk factors. There have also been in the past years, a few descriptions of uterine nonepithelial malignancies occurring after tamoxifen. We describe five recent cases of uterine carcinosarcomas occurring under/after tamoxifen administered in an adjuvant setting. None of these patients had received prior pelvic radiation therapy. Their median age at the diagnosis of breast cancer was 58 years (41-68), and 69 years (50-84) at the diagnosis of uterine carcinosarcoma. The median length of exposure to tamoxifen was 9 years (5-20), and the median time from the initiation of tamoxifen to the diagnosis of the uterine malignancy (latency period) 9 years (7-20). All patients presented with an advanced stage (IIA-IVA). Our data, together with those of the literature, plead for a causal role of a prolonged exposure to tamoxifen on the subsequent development of uterine carcinosarcoma. The long latency period observed even in patients receiving only 5 years of treatment leads us also to consider a prolonged gynecologic follow-up of the patients.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents, Hormonal / administration & dosage
  • Antineoplastic Agents, Hormonal / adverse effects*
  • Breast Neoplasms / diagnosis
  • Breast Neoplasms / drug therapy
  • Carcinosarcoma / chemically induced*
  • Carcinosarcoma / pathology*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Long-Term Care
  • Middle Aged
  • Risk Assessment
  • Survival Rate
  • Tamoxifen / administration & dosage
  • Tamoxifen / adverse effects*
  • Uterine Neoplasms / chemically induced*
  • Uterine Neoplasms / pathology*


  • Antineoplastic Agents, Hormonal
  • Tamoxifen