타목시펜 사용과 연관되어 빠르게 진행하는 다발성 자궁내막폴립 1예

A Case of Tamoxifen-Associated Rapid Growing and Multiple Endometrial Polyps

  • 이희준 (서울대학교 의과대학 산부인과학교실) ;
  • 김훈 (서울대학교 의과대학 산부인과학교실) ;
  • 구승엽 (서울대학교 의과대학 산부인과학교실) ;
  • 한원식 (서울대학교 의과대학 외과학교실) ;
  • 김석현 (서울대학교 의과대학 산부인과학교실) ;
  • 최영민 (서울대학교 의과대학 산부인과학교실) ;
  • 김정구 (서울대학교 의과대학 산부인과학교실) ;
  • 문신용 (서울대학교 의과대학 산부인과학교실)
  • Lee, Hee-Jun (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Kim, Hoon (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Ku, Seung-Yup (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Han, Won-Shik (Department of Surgery, Seoul National University College of Medicine) ;
  • Kim, Seok-Hyun (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Choi, Young-Min (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Kim, Jung-Gu (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Moon, Shin-Yong (Department of Obstetrics and Gynecology, Seoul National University College of Medicine)
  • 투고 : 2010.02.12
  • 심사 : 2010.04.29
  • 발행 : 2010.06.30

초록

유방암의 치료는 수술, 항암치료 및 방사선 치료 등의 주 치료법이 있으며, 유방암 환자에서 주 치료 후 보조적 치료 수단으로 호르몬 치료가 사용된다. 이 호르몬 치료에는 타목시펜이 가장 보편적으로 사용되며, 타목시펜은 체내에서 항에스트로겐 효과를 보여 유방암 치료에 도움을 주며 유방암의 재발방지에도 효과가 있다고 알려져 있다. 그러나 타목시펜의 부작용 또한 여러 가지가 있으며 문헌에 보고된 것으로는 자궁내막폴립, 자궁내막증식증, 자궁내막암 등이 있다고 알려져 있다. 본원에서도 유방암으로 수술 치료를 시행 받은 후 보조적 치료로서 호르몬 제제인 타목시펜을 사용하여 왔으며 이러한 환자들은 모두 외과와 협진하여 산부인과 외래로 추적 관찰하고 있다. 최근에 본원산부인과 외래로 추적 관찰 중인 타목시펜 사용 환자 중에서, 호르몬 치료 시작 3개월 후의 단기간 내에 빠르게 진행하는 다발성의 자궁내막폴립의 1예가 발견되었으며, 이는 타목시펜의 부작용으로 발생한 것으로 사료된다. 이에 저자는 유방암 수술 후 보조적 치료로 타목시펜을 사용한 환자들 중 우연히 발견된 빠르게 진행하는 다발성의 자궁내막폴립의 1예를 문헌고찰과 함께 보고하는 바이다.

The antiestrogen tamoxifen is currently the most commonly used adjuvant treatment of breast cancer with antiestrogenic effect on mammary tissue. However, it is also associated with endometrial abnormalities, including hyperplasia, polyps, carcinoma, mostly interpreted as evidence of estrogenic effect on the endometrium. Previously, tamoxifen-associated polyp in breast cancer has been reported in the literature. Most studies had a long follow-up period and tamoxifen-associated polyp developed more than 1 year after tamoxifen treatment. In this case, we report an unusual case of rapid growing and multiple endometrial polyps that were developed only after 3 months' tamoxifen treatment in a postmenopausal breast cancer patient who received quadrant mastectomy with a brief review of literature.

키워드

참고문헌

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