Intrauterine device found in an ovarian tumor

Abstract

Rationale: Intrauterine devices (IUDs) are one of the most common and effective methods of contraception worldwide. Migration of an IUD to an extrauterine site is a rare complication. The aim of this study was to report an extremely rare case in which an IUD was found in an ovarian tumor. Patient concerns: A 63-year-old Chinese woman presented with vaginal bleeding and lower abdominal pain during hospitalization due to pneumonia. Preoperative imaging showed bilateral cystic masses in the adnexal region, and ring hyperdensity was found in the right ovarian mass. Endometrial thickening and multiple uterine leiomyomas were found on ultrasonography. Hysteroscopy showed partial septate uterus and a small endometrial polyp. Diagnosis: Bilateral ovarian cystadenomas with perforation of the IUD into the right ovarian tumor were considered based on preoperative imaging and the patient's medical history. Furthermore, early endometrial carcinoma was suspected. Interventions: The patient underwent hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. A stainless steel ring IUD was confirmed within the right ovarian tumor during the operation. Outcomes: The pathology results demonstrated bilateral ovarian serous cystadenofibromas with focal epithelial proliferation and endometrial atypical hyperplasia with malignant transformation. The patient has been followed up for 7 months, and there has been no recurrence at present. Lessons: The presence of an IUD within an ovarian tumor is extremely rare. This is the second reported case in the English literature describing an extrauterine IUD within an ovarian tumor. The correlation between ovarian cancer tumorigenesis and IUD translocation is unclear and requires further investigation.