A 50-year-old woman on tamoxifen for breast cancer for 3 years presents with vaginal spotting. Transvaginal ultrasound shows an endometrial thickness of 6 mm with a focal lesion. What is the most likely endometrial pathology associated with tamoxifen use?
- A Endometrial polyp ✓
- B Endometrioid adenocarcinoma
- C Uterine serous carcinoma
- D Leiomyosarcoma
Correct answer: A. Endometrial polyp
Explanation
Tamoxifen has an estrogenic effect on the endometrium, leading to endometrial polyps, hyperplasia, and an increased risk of endometrioid adenocarcinoma. While polyps are the most common finding, any bleeding in a tamoxifen user warrants biopsy to rule out malignancy, as standard ultrasound cutoffs are unreliable.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.