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Hormone-related tumors in transsexuals receiving treatment with cross-sex hormones

Department of Obstetrics and GynecologyErlangen University Hospital, Universitaetsstr. 21-23, D-91054 Erlangen, Germany¹ Department of EndocrinologyVU University Medical Center, de Boelelaan 1117, 1081 HV Amsterdam, The Netherlands

(Correspondence should be addressed to L Gooren; Email: louisjgooren{at}gmail.com)

Objective: To assess the risk of development of hormone-related tumors in transsexuals receiving treatment with cross-sex hormones.

Design: Description of cases of transsexuals who have developed a hormone-related malignancy observed in their own clinic or reported in the literature. Recommendations for early diagnosis and prevention are presented.

Methods: Review of the literature in PubMed.

Results: In male-to-female transsexuals receiving estrogen administration, lactotroph adenomas, breast cancer, and prostate cancer have been reported. In female-to-male transsexuals receiving treatment with testosterone, a single case of breast carcinoma and several cases of ovarian cancer have been reported. So far endometrial cancer has not been encountered though it remains a potential malignant development.

Conclusions: There are so far only a few cases of hormone-related cancer in transsexuals. There may be an underreporting. The probability of a hormone-related tumor increases with the duration of exposure to cross-sex hormones and the aging of the population of transsexuals.

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