Florid Endocervical Microglandular Hyperplasia in Association with Tamoxifen Treatment

Background: Although tamoxifen has well documented oestrogen-like effects in the endometrium and ectocervical squamous epithelium, its effects on the endocervix are poorly documented. Case report: We report a case of an 88 year-old woman who presented with postmenopausal bleeding after receiving tamoxifen for 16 months following a diagnosis of Grade 2 invasive and in situ carcinoma of breast. Endometrial biopsy was performed revealing either atypical hyperplasia or adenocarcinoma. She underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy and lymph gland sampling. Histopathological examination of the uterus showed an endometrioid carcinoma (FIGO Grade 2) at the endometrium. In addition, there was extensive florid endocervical microglandular hyperplasia. Conclusion: Endocervical microglandular hyperplasia is usually seen in woman of reproductive age, particularly in association with pregnancy and contraceptive use. It is unusual in postmenopausal woman and its presence in this 88 year-old tamoxifentreated patient implicates tamoxifen as a course of endocervical microglandular hyperplasia in this instance.