Ovarian hyperstimulation syndrome in a patient treated with tamoxifen for breast cancer

Objective: To report the management of a rare case of ovarian hyperstimulation syndrome (OHSS) induced by tamoxifen therapy for breast cancer in a 50-year-old woman.

Design: Case report.

Setting: Gynecology outpatient department of a university hospital.

Patient(s): A 50-year-old premenopausal patient with a history of breast cancer was prescribed adjuvant treatment with tamoxifen.

Intervention(s): Temporary discontinuation of tamoxifen therapy resolved symptoms, but resumption of tamoxifen caused a recurrence of symptoms. Surgical bilateral salpingo-oophrectomy was therefore performed.

Main Outcome Measure(s): Resolution of symptoms of OHSS.

Result(s): Bilateral salpingo-oophrectomy rendered the patient postmenopausal and enabled the commencement of the aromatase inhibitor anastrozole as an alternative adjuvant therapy for breast cancer.

Conclusion(s): Tamoxifen-induced OHSS is rare. Furthermore, OHSS is very rare in the older female. OHSS usually resolves with temporary discontinuation of tamoxifen, however, the recurrence of symptoms when resuming tamoxifen is better treated with bilateral salpingo-oophorectomy to enable adjuvant treatment with anastrazole. (Fertil Steril (R) 2011; 95: 2429. e5-e7. (C) 2011 by American Society for Reproductive Medicine.)