Malignant endometrial polyp in woman with the levonorgestrel intrauterine system - a case report

Gynecol Endocrinol. 2019 Feb;35(2):112-114. doi: 10.1080/09513590.2018.1491028. Epub 2018 Nov 19.

Abstract

The levonorgestrel-releasing intrauterine system (LNG-IUS) is widely used and recommended as a reliable contraceptive. It also acts by opposing the effects of estrogen on the endometrium, thereby preventing development of endometrial hyperplasia and its possible malignant transformation. This case describes a 52-year-old multiparous amenorrhoeic patient who was seen in the gynecology outpatient department for a routine control 46 months after the insertion LNG-IUS as contraception. Hysteroscopy with a target biopsy following suspicious ultrasound scan confirmed well-differentiated endometrioid adenocarcinoma. Ultrasound scan prior to inserting LNG-IUS revealed normal 5 mm thin endometrium with the sharp edges. Uterine bleeding before the LNG-IUS insertion was regular and not excessive and the woman has remained amenorrhoeic after the LNG-IUS insertion. We present a case of the growth of a polyp-shaped endometrial carcinoma in a LNG-IUS asymptomatic user.

Keywords: Endometrial cancer; endometrium; levonorgestrel-releasing intrauterine system.

Publication types

  • Case Reports

MeSH terms

  • Asymptomatic Diseases
  • Biopsy
  • Carcinoma, Endometrioid / diagnostic imaging*
  • Carcinoma, Endometrioid / pathology
  • Contraceptive Agents, Female / therapeutic use*
  • Endometrial Neoplasms / diagnostic imaging*
  • Endometrial Neoplasms / pathology
  • Female
  • Humans
  • Hysteroscopy
  • Intrauterine Devices, Medicated*
  • Levonorgestrel / therapeutic use*
  • Middle Aged
  • Polyps / diagnostic imaging*
  • Polyps / pathology
  • Ultrasonography

Substances

  • Contraceptive Agents, Female
  • Levonorgestrel