Endometrial adenocarcinoma following insertion of the levonorgestrel-releasing intrauterine system (mirena) in a 36-year-old woman

The levonorgestrel-releasing intrauterine system (LNG-IUS), commonly referred to as mirena, is an effective form of contraception, which is widely used as an intrauterine device. It has a 32-mm long-shaped plastic frame that holds a reservoir (on the vertical stem) of 52 mg of levonorgestrel mixed with polydimethylsiloxane to allow a steady release of 20 mu g of levonorgestrel per day within the endometrial cavity through a rate-limiting surface membrane. Apart from contraceptive purpose, it is also now commonly used in the management of heavy menstrual blood loss. This study included a 36-year old woman who developed endometrial cancer following the insertion of the LNG-IUS. Her main presentation was irregular vaginal bleeding, which is a common finding in women using this form of contraception. Although we would advice caution in investigating such women, the LNG-IUS remains a relatively safe method of contraception.