FIBROID GROWTH IN RESPONSE TO HIGH-DOSE PROGESTOGEN

Objective: To challenge the conventional belief that leiomyomata are estrogen-dependent tumors by presentation of a case report suggesting high-dose progestogen therapy is associated with a dramatic increase in size of a fibroid uterus. Design: Case report. Setting: British university hospital. Patient: One white woman treated with tamoxifen and high-dose megestrol acetate for breast carcinoma. Interventions: Megestrol acetate therapy withdrawn. Main Outcome Measure: Uterine size. Results: While taking tamoxifen and high-dose megestrol acetate, the patient suffered a dramatic increase in size of her fibroid uterus, which reversed when the progestogen was withdrawn. Conclusion: This case report suggests that P may be important in fibroid growth.