Use of aromatase inhibitors in menopausal deep endometriosis: a case report and literature review

Abstract

We report and review the clinical effectiveness of aromatase inhibitors in a patient with refractory, recurrent and infiltrating endometriosis. We demonstrate excellent clinical, radiological and endoscopic responses after failure of multiple other modalities. Our case and the literature show that single-agent letrozole is capable to treat deep infiltrative endometriosis involving the rectum and the urinary tract. The use of aromatase inhibitor treatment of endometriosis in postmenopausal women makes sense, is safe and is well tolerated. Difficult cases of deep infiltrative endometriosis might require use of combined surgical and medical treatment modalities. Multidisciplinary involvement of the gynecologist, bowel surgeon, urologist and invasive radiologist might be needed. Aromatase inhibitors should be considered to be an integral part of the armamentarium in the management of women with endometriosis, especially in refractory cases that have failed conventional therapeutic modalities.

摘要

我们报道并综述临床芳香化酶抑制剂治疗难治性、复发性和浸润性子宫内膜异位症的疗效。在其他多种治疗方法失效后, 我们的治疗在临床、影像学和内镜表现上存在良好的疗效。我们的病例和文献表明, 单用来曲唑能够治疗累及直肠和泌尿道的深层浸润性子宫内膜异位症。应用芳香化酶抑制剂治疗绝经后女性的子宫内膜异位症是合理、安全且耐受性良好的。深部浸润性子宫内膜异位症的疑难病例可能需要应用内外科联合治疗方式。可能需要妇科医生、胃肠外科医生、泌尿外科医生和侵入性放射科医生的多学科参与。芳香化酶抑制剂应被视为子宫内膜异位症女性治疗中不可或缺的一部分, 尤其是针对常规治疗方法失效的难治性病例。

Keywords:

• Menopause
• aromatase inhibitors
• vaginal bleeding
• endometriosis

Acknowledgements

The authors acknowledge the support and efforts of Wilma Greston.

Potential conflict of interest

None of the authors has any conflict of interest that is related to the manuscript.

Source of funding

There was no funding associated with the case.