In our 2 previous papers published in this Journal, we had 5 cases of uterine malignancies developing after long term use of IUCD's. In the present paper 2 cases of such association are to be added. One case ATH with right adnexectomy was performed for persisting vaginal bleeding after 22 years of Lippes Loop application and recurrence 8 years after the first operation. Pathological diagnosis is endometrial stromal sarcoma. The other case is a leiomyosarcoma developing after 25 years of Lippes Loop application. Although no cause and effect relationship between IUCD use and uterine malignancy in human beings has been proved, the increase in such cases suggests to us that long term application should be avoided, particularly in view of the positive animal experiments. The successive detection of such cases in a relatively short period of time prompts us to make further studies to gain a deeper insight into such associations.

A case of endometrial stromal sarcoma associated with the use of an IUCD is t o be added t o our previous report which included 4 cases of uterine malignancies developing after long-term use of IUCD. In the present case, the IUCD (Lippes loop and nylon ring) had been used for 6 years with interruptions of 1-6 months. When the IUCD is associated with irregular bleeding, it is important t o emphasize that besides irregular bleeding as a complication of IUCD, abortion, ectopic pregnancies and uterine malignancies should also be taken into consideration. Endometrial stromal sarcoma is a very rare uterine malignancy, therefore, the association of this tumor with IUCD must count as a great rarity. A case of this kind has never before appeared in the literature. Key words: e n d o m e t r i a l strornal sarcoma, I U C D , association of I U C D w i t h u t e r i n e malignancies