Therefore, it is conceivable that these two agents could produce comparable embryotoxic effects if they function in a like way during embryogenesis. While a larger spectrum of anomalies is characteristic of retinoic acid embryopathy, the specific craniofacial anomalies include facial asymmetry, microtia, micrognatha and U-shaped cleft of the secondary palate, that is, malformations seen in the two tamoxifen exposed infants. case and Pierre Robin sequence reported here-have also both been observed in isotretinoin exposed infants. It is noteworthy that the two patterns of craniofacial malformations in tamoxifen exposed infants-Goldenhar syndrome in Cullins' et al. A child with severe micrognathia and cleft palate was born. The mother became pregnant while undergoing tamoxifen therapy for breast cancer. We report on the fourth case of a tamoxifen-associated craniofacial anomaly. Cullins' case of Goldenhar syndrome is also a craniofacial disorder and thus represented the third such case. published a case report entitled "Goldenhar's Syndrome Associated with Tamoxifen Given to the Mother During Gestation." At the time of publication, the authors noted that the manufacturer of tamoxifen knew of two cases associated with tamoxifen administration which resulted in congenital craniofacial defects. While the evidence of tamoxifen's effects on humans in utero is minimal, animal studies have shown evidence of teratogenicity, hence the FDA's class D categorization of the drug. Tamoxifen is a nonsteroidal antiestrogen used as the current adjuvant endocrine treatment of choice for premenopausal women treated for breast cancer and its potential for causing fetal harm during pregnancy remains inconclusive.
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