Endometrioid Adenocarcinoma after Insertion of a Levonorgestrel-releasing Intrauterine System

Flemming, Rhonda; Sathiyathasan, Sahathevan; Jackson, Anne

doi:10.1016/j.jmig.2008.08.016

Cited by 16 publications

(6 citation statements)

References 13 publications

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“…Regarding this case study, the development of endometrial cancer was not prevented by the presence of the LNG‐IUS despite negative hysteroscopy prior to insertion. Similar cases have been documented in four previous individual case reports (19–22). This patient was at an increased risk of developing the condition given her morbid obesity.…”

Section: Discussionsupporting

confidence: 86%

Development of endometrioid adenocarcinoma despite Levonorgestrel‐releasing intrauterine system: a case report with discussion and review of the RCOG/BSGE Guideline on the Management of Endometrial Hyperplasia

Meer

Hanna

2016

Clinical Obesity

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Obesity is a significant risk factor for the development of endometrial hyperplasia and cancer. More conservative prevention and management strategies are attractive due to the increased surgical risk and complication rates associated with obesity. The Levonorgestrel-releasing intrauterine system (LNG-IUS, Mirena) has been shown to reduce the risk of developing endometrial cancer. The recent joint Green Top Guideline on the Management of Endometrial Hyperplasia published by the Royal College of Obstetricians and Gynaecologists (RCOG) with the British Society for Gynaecological Endoscopy (BSGE) recommends the LNG-IUS for the medical management of endometrial hyperplasia without atypia. This case study reports on the development of endometrioid adenocarcinoma despite the presence of an LNG-IUS following a negative hysteroscopy in a 56-year-old woman with morbid obesity. This report highlights the need for patients and clinicians to remain vigilant to the early warning signs of developing endometrial cancer, especially in those at an increased risk secondary to obesity.

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Section: Discussionsupporting

confidence: 86%

Development of endometrioid adenocarcinoma despite Levonorgestrel‐releasing intrauterine system: a case report with discussion and review of the RCOG/BSGE Guideline on the Management of Endometrial Hyperplasia

Meer

Hanna

2016

Clinical Obesity

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“…In their three cases who had hysterectomy for persistent atypical hyperplasia, uterine histopathologic study indicated atypical hyperplasia in two cases and stage IA endometrial cancer in the third case [34]. Additional cases of persistent atypical hyperplasia or progressing into cancer in the presence of LNG-IUS have been reported [35,36]. These observations together with the two cases of endometrial cancer raise the question of whether the LNG-IUS should be used in the presence of atypical endometrial hyperplasia.…”

Section: Discussionmentioning

confidence: 98%

The Levonorgestrel Intrauterine System Is an Effective Treatment in Selected Obese Women with Abnormal Uterine Bleeding

Vilos

Marks

Tureanu

et al. 2011

Journal of Minimally Invasive Gynecology

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“…Only seven cases were reported in the literature to date (table 1). [11][12][13][14][15][16] Our patient is unique due to Figure 3 The same field as in figure 2 and with the oestrogen receptor stain, which shows strong nuclear staining of the tumour cells (strongly positive).…”

Section: Discussionmentioning

confidence: 89%

Development of endometrial cancer after long-term usage of the levonorgestrel-releasing intrauterine system

2021

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A 52-year-old long-term user of the levonorgestrel-releasing intrauterine system (LNG-IUS) presented with vaginal bleeding. Endometrial biopsy was performed and revealed endometrioid adenocarcinoma. The patient had a laparoscopic hysterectomy and bilateral salpingo-oophorectomy. Endometrial cancer is rare in women with LNG-IUS as only seven cases have been published in the literature. Although scientific evidence shows LNG-IUS has a protective effect on the endometrium from developing cancer, our report highlights the importance of clinicians to be vigilant in cases of women with LNG-IUS who develop intermittent vaginal bleeding.

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Endometrioid Adenocarcinoma after Insertion of a Levonorgestrel-releasing Intrauterine System

Cited by 16 publications

References 13 publications

Development of endometrioid adenocarcinoma despite Levonorgestrel‐releasing intrauterine system: a case report with discussion and review of the RCOG/BSGE Guideline on the Management of Endometrial Hyperplasia

Development of endometrioid adenocarcinoma despite Levonorgestrel‐releasing intrauterine system: a case report with discussion and review of the RCOG/BSGE Guideline on the Management of Endometrial Hyperplasia

The Levonorgestrel Intrauterine System Is an Effective Treatment in Selected Obese Women with Abnormal Uterine Bleeding

Development of endometrial cancer after long-term usage of the levonorgestrel-releasing intrauterine system

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