<b>Some Annotated Medical Journal Citations </b>

The abstracts below have been edited.
The full abstract of the Medical Journal articles are available on Pubmed.
To obtain them, search Pubmed for &&url
You can also search Pubmed for &&url
As well as &&url


1. Obstet Gynecol 1998 Oct;92(4 Pt 2):664-6 
<b>Aborted leiomyosarcoma after treatment with leuprolide acetate. </b>
Mesia AF, Williams FS, Yan Z, Mittal K. 
Department of Pathology, Kaplan Comprehensive Cancer Center, New York University Medical Center, New York 10016, USA. 

"Leuprolide acetate has been used to decrease uterine size and shrink leiomyomata. In carefully selected patients, its treatment benefits are well recognized. However, if leuprolide acetate is inadvertently given to a patient with an unsuspected leiomyosarcoma, complications may occur... A patient presumed to have leiomyomata was treated with monthly injections of leuprolide acetate... In the third month of treatment, unusual manifestations, including increased bleeding, aborting mass, urinary retention, and severe pain, occurred suggesting a possible malignancy and requiring immediate operation... The use of leuprolide acetate can delay the diagnosis and treatment of leiomyosarcoma and thus may increase the risk of morbidity and affect the treatment outcome of patients with leiomyosarcoma. The histologic changes ascribed to leuprolide acetate treatment in leiomyomata also were seen in this leiomyosarcoma." 
&&url PMID: 9764655


2. Gynecol Oncol 1993 May;49(2):266-7 
<b>Gonadotropin releasing hormone (GnRH) agonist therapy for reduction of leiomyoma volume. </b>
Murphy NJ, Wallace DL. 
Department of Obstetrics and Gynecology, St. Luke's Hospital, Kansas City, Missouri 64111. 
 
"A patient with menorrhagia, dysmenorrhea, and an enlarged uterus was treated with a GnRH agonist for leiomyoma volume reduction. A laser-assisted myomectomy yielded five tumors that did not appear to be well demarcated and had a combined weight of only 30 g. Postoperative pathologic evaluation revealed leiomyosarcoma with 22 mitoses per 10 high-power fields. The 8-month delay in therapy was associated with Stage IV, grade 3 disease at diagnosis. In rare cases GnRH agonist therapy may palliate symptoms and delay definitive surgical therapy of leiomyosarcoma, resulting in more advanced disease at diagnosis." 
&&url PMID: 8504999


3. Obstet Gynecol 1990 Mar;75(3 Pt 2):529-32 
<b>Unsuspected leiomyosarcoma: treatment with a gonadotropin-releasing hormone analogue.</b> 
Meyer WR, Mayer AR, Diamond MP, Carcangiu ML, Schwartz PE, DeCherney AH. 
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut. 

"We present a case of a 46-year-old woman evaluated for abnormal uterine bleeding and an enlarged uterus, with normal endometrial sampling. Three months of leuprolide acetate injections resulted in a nonenlarging uterus and resolution of iron deficiency anemia and menorrhagia. Intraoperative examination suggested leiomyosarcoma, which was confirmed by postoperative permanent histologic sections. Residual uterine sarcomatous disease was confirmed on reexploration. Similar cases will continue to raise arguments against conservative hormonal intervention in the perimenopausal woman with an enlarged uterus. As the gynecologist gains familiarity with the use of gonadotropin-releasing hormone analogue therapy in the treatment of myomatous uteri, the criteria for hysterectomy will become less rigid and the potential for delay in the diagnosis and treatment of sarcomatous disease will become more common. Physicians must be cognizant of this potential complication of conservative therapy of leiomyomata uteri." 
&&url PMID: 2106109 

<b>Lupron Depot and Breast & Ovarian Cancer 
Annotated References </b>

Search Pubmed for Lupron Depot and Breast Cancer
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=search&db=PubMed&term=lupron%20cancer%20breast
Search Pubmed for Lupron Depot and Ovarian Cancer
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=search&db=PubMed&term=lupron%20cancer%20ovary
 

4. Zentralbl Gynakol 1998;120(6):284-92 
<b>[Primary endocrine therapy as pre- and perimenopausal metastatic breast carcinoma with leuprorelin acetate depot.</b>
 German Leuprorelin Study Group]. [Article in German] Untch M. 

"Leuprorelinacetate-depot is a safe and effective palliative drug for pre- and perimenopausal metastatic breast cancer patients. Like other GnRH-agonists which have been evaluated for this indication, leuprorelinacetate-depot can be used as first-line endocrine treatment in these patients". 
&&url PMID: 9659699


5. Eur J Gynaecol Oncol 1996;17(4):286-8 
<b>Leuprolide acetate as a salvage-therapy in relapsed epithelial ovarian cancer.</b>
Marinaccio M, D'Addario V, Serrati A, Pinto V, Cagnazzo G. I 
Department of Obstetrics and Gynecology, University of Bari Medical School, Italy.

""Treatment is well-tolerated and no toxicity has been noted. These data stress the significant activity of Leuprolide acetate as a salvage therapy in patients with relapsed advanced epithelial ovarian cancer after previous platinum-based chemotherapies." 
&&url PMID: 8856307


6. J Clin Endocrinol Metab 1993 Jun;76(6):1439-45 
<b>A prospective, randomized trial of gonadotropin-releasing hormone agonist plus estrogen-progestin or progestin "add-back" regimens for women with leiomyomata uteri.</b> 
Friedman AJ, Daly M, Juneau-Norcross M, Rein MS, Fine C, Gleason R, Leboff M. 

Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115. 
Treatment of women with myomas with GnRH agonists (GnRH-a) for 3-6 months will result in profound hypoestrogenism, a significant but temporary reduction in uterine volume, and menstrual suppression. Long-term (i.e. > 6 months) treatment with a GnRH-a is not recommended because of accelerated bone resorption and the presence of hypoestrogenic symptoms. 
&&url PMID: 8501148 



<b>Lupron Depot AND Endometrial Cancer </b>

7. Arch Gynecol Obstet 2000 Feb;263(3):148-9 
<b>Uterine adenocarcinoma after GnRH agonist treatment.</b> 
Dessole S, Ruiu GA, Cherchi PL, Ambrosini G. 

We report endometrial adenocarcinoma in two patients shortly after suspending GnRH-agonist treatment for menometrorrhagia and uterine fibromata. 
&&url PMID: 10763848 


8. Gynecol Oncol 1998 Dec;71(3):458-60 Low-grade endometrial stromal sarcoma preoperative treatment with Depo-Lupron and Megace. Scribner DR Jr, Walker JL. Department of Gynecologic Oncology, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma, 73190, USA. Two doses of depot Lupron 7.5mg, and Megace 160mg/day, were given to control bleeding and shrink the low grade, inoperable ESS tumor mass in a 46 year old woman. This neoadjuvant therapy allowed for shrinkage of tumor mass, and surgical resection with a TAH with BSO. Additional research is necessary to define the exact role of chemo, radiation, and hormal therapy. [abstract rewritten because of copyright. Ed.]. Copyright 1998 Academic Press. 
&&url PMID: 9887250


9. Gynecol Oncol 1998 Dec;71(3):396-403 
<b>Differential inhibitory effects on human endometrial carcinoma cell growth of luteinizing hormone-releasing hormone analogues.</b> 
Borri P, Coronnello M, Noci I, Pesciullesi A, Peri A, et. al. 
Istituto di Clinica Ginecologica ed Ostetrica, Universita degli Studi di Firenze, Viale Morgagni 85, Florence, 50134, Italy.  Copyright 1998 Academic Press. 
&&url PMID: 9887238

10. Depress Anxiety 1998;7(4):171-7 
<b>Depressive symptoms associated with gonadotropin-releasing hormone agonists.</b> 
Warnock JK, Bundren JC, Morris DW. 
Department of Psychiatry, University of Oklahoma Health Sciences Center-Tulsa, Oklahoma 74129, USA. 
&&url PMID: 9706454 


11. J Reprod Med 1996 Jun;41(6):415-21 
<b>GnRH agonists before surgery for uterine leiomyomas. A review.</b> 
Crosignani PG, Vercellini P, Meschia M, Oldani S, Bramante T. L. Mangiagalli 
Obstetrics and Gynecologic Clinic, University of Milan, Italy. 
&&url PMID: 8799917
