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Fibroid growth in response to high-dose progestogen
M Harrison-Woolrych1, R Robinson
1Department of Obstetrics and Gynaecology, University of Cambridge, Rosie Maternity Hospital, United Kingdom.
Fertility and Sterility
|July 1, 1995
Summary
This case report challenges the estrogen-dependency of uterine fibroids. High-dose progestogen therapy significantly increased fibroid size, which reversed upon withdrawal, suggesting progestogens may drive fibroid growth.
Area of Science:
- Gynecology
- Endocrinology
- Oncology
Background:
- Uterine leiomyomata (fibroids) are conventionally considered estrogen-dependent tumors.
- This case report investigates the role of progestogens in fibroid growth.
Observation:
- A patient with breast carcinoma received tamoxifen and high-dose megestrol acetate.
- During treatment, a significant increase in uterine fibroid size was observed.
Findings:
- High-dose megestrol acetate therapy was associated with dramatic uterine fibroid growth.
- Fibroid size regressed upon withdrawal of megestrol acetate, suggesting progestogen influence.
Implications:
- This case suggests progestogens, not just estrogen, may play a critical role in uterine fibroid development and growth.
- Further research into progestogen receptor pathways in leiomyomata is warranted.