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Endometrial Cancer in a Transgender Man with Prolonged Exogenous Testosterone Use.

Stephanie Gill¹, Michelle Anderson, Joannie Neveu

¹Department of Obstetrics and Gynecology and the Department of Radiology, Memorial University of Newfoundland, and the Bliss Murphy Cancer Center, St. John's, Newfoundland, Canada.

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Summary

Transgender men on testosterone therapy require monitoring for potential gynecologic cancers. This case highlights challenges in managing endometrial cancer while continuing hormone therapy.

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Area of Science:

Oncology
Endocrinology
Transgender Health

Background:

Hormone therapy (HT) is integral to medical gender transition for transgender males.
Monitoring for gynecologic health, including prompt assessment of abnormal bleeding, is crucial for transgender individuals on HT.

Purpose of the Study:

To report a case of advanced endometrial adenocarcinoma in a transgender man receiving testosterone therapy.
To discuss the implications of long-term androgen use on malignancy development.
To explore challenges in managing reproductive organ cancers in transgender males undergoing hormone therapy.

Main Methods:

A case report of a 33-year-old transgender man on exogenous testosterone therapy.
Diagnosis of stage IV endometrioid endometrial adenocarcinoma.
Surgical resection for symptom control and palliative chemotherapy.
Tumor analysis for androgen receptor status.
Multidisciplinary discussion regarding continuation of testosterone therapy post-treatment.

Main Results:

Stage IV endometrioid endometrial adenocarcinoma was diagnosed in a transgender man on testosterone therapy.
The tumor was androgen receptor-negative.
Testosterone therapy was restarted postoperatively after risk-benefit assessment.

Conclusions:

Long-term androgen use may have uncharacterized risks for malignancy development.
Managing gynecologic cancers in transgender males can be complex due to the need for ongoing androgen therapy.
Further research is needed to understand the long-term implications of hormone therapy in transgender populations.