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Successful treatment of early endometrial carcinoma by local delivery of levonorgestrel: a case report.

Wildemeersch D, Anderson E, Lambein K, Pauwels P, Dhont M - Obstet Gynecol Int (2010)

Bottom Line: We describe a case of a 67-year-old Caucasian woman with an early, moderately-differentiated adenocarcinoma of the endometrium.A levonorgestrel-releasing intrauterine system was inserted, which she tolerated well.Examination after 24 months showed a very thin endometrium, indicating complete remission.

View Article: PubMed Central - PubMed

Affiliation: Gynecological Outpatient Clinic and Training Center, Rooseveltlaan 43/44, 9000 Ghent, Belgium.

ABSTRACT
We describe a case of a 67-year-old Caucasian woman with an early, moderately-differentiated adenocarcinoma of the endometrium. A levonorgestrel-releasing intrauterine system was inserted, which she tolerated well. A full D&C, following removal of the device, was performed after 9 months, confirming absence of tumoral tissue. Examination after 24 months showed a very thin endometrium, indicating complete remission.

No MeSH data available.


Related in: MedlinePlus

3D-sonographic view of normal uterus (transverse section) with LNG-IUS in center.
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fig4: 3D-sonographic view of normal uterus (transverse section) with LNG-IUS in center.

Mentions: In May 2008, a 67-year-old woman residing in the United States of America presented with a history of postmenopausal bleeding since January 2008. She had been using local estrogen treatment for vaginal dryness without any systemic hormonal therapy. She had been diagnosed with an endometrial carcinoma and was advised to undergo surgery. As she wanted to avoid surgery, she sought an alternative treatment and consulted DW. The clinical examination was normal, with normal body weight, and a transvaginal ultrasound scan showed normal appearance of the myometrium and endometrium. An outpatient endometrial pipelle biopsy was performed which revealed a moderately differentiated adenocarcinoma (Figure 1) with minimal myometrial invasion (Clinical FIGO stage I). An LNG-IUS (Femilis, Contrel Research, Ghent, Belgium) releasing 20 μg of LNG/d was inserted (Figure 2), and advice was given to request a repeat biopsy within the next 3 to 6 months. Spotting continued for several weeks and then stopped. As the patient was completely free of symptoms 6 months after insertion of the LNG-IUS, a pelvic transvaginal ultrasound was performed, including a 3D-ultrasound and a Duplex Doppler with Color Flow Mapping. The uterus appeared completely normal, and there was no evidence of any pathology. The endometrium showed normal thickness, and there was no evidence of any endometrial abnormality or myometrial invasion (Figures 3 and 4). The LNG-IUS was identified in situ, as expected. Three months later, in order to ascertain complete remission, the LNG-IUS was removed, and a full D&C was performed. The uterine sound length was 6 cm. The whole cavity was explored, and very scant tissue was removed. Histological examination of the specimen revealed a secretory endometrium without signs of hyperplasia or atypia (Figure 5). A mini Femilis LNG-IUS (crossarm 24 mm long and 28 mm long and 2.0 wide drug compartment) was inserted as a precaution.


Successful treatment of early endometrial carcinoma by local delivery of levonorgestrel: a case report.

Wildemeersch D, Anderson E, Lambein K, Pauwels P, Dhont M - Obstet Gynecol Int (2010)

3D-sonographic view of normal uterus (transverse section) with LNG-IUS in center.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2963141&req=5

fig4: 3D-sonographic view of normal uterus (transverse section) with LNG-IUS in center.
Mentions: In May 2008, a 67-year-old woman residing in the United States of America presented with a history of postmenopausal bleeding since January 2008. She had been using local estrogen treatment for vaginal dryness without any systemic hormonal therapy. She had been diagnosed with an endometrial carcinoma and was advised to undergo surgery. As she wanted to avoid surgery, she sought an alternative treatment and consulted DW. The clinical examination was normal, with normal body weight, and a transvaginal ultrasound scan showed normal appearance of the myometrium and endometrium. An outpatient endometrial pipelle biopsy was performed which revealed a moderately differentiated adenocarcinoma (Figure 1) with minimal myometrial invasion (Clinical FIGO stage I). An LNG-IUS (Femilis, Contrel Research, Ghent, Belgium) releasing 20 μg of LNG/d was inserted (Figure 2), and advice was given to request a repeat biopsy within the next 3 to 6 months. Spotting continued for several weeks and then stopped. As the patient was completely free of symptoms 6 months after insertion of the LNG-IUS, a pelvic transvaginal ultrasound was performed, including a 3D-ultrasound and a Duplex Doppler with Color Flow Mapping. The uterus appeared completely normal, and there was no evidence of any pathology. The endometrium showed normal thickness, and there was no evidence of any endometrial abnormality or myometrial invasion (Figures 3 and 4). The LNG-IUS was identified in situ, as expected. Three months later, in order to ascertain complete remission, the LNG-IUS was removed, and a full D&C was performed. The uterine sound length was 6 cm. The whole cavity was explored, and very scant tissue was removed. Histological examination of the specimen revealed a secretory endometrium without signs of hyperplasia or atypia (Figure 5). A mini Femilis LNG-IUS (crossarm 24 mm long and 28 mm long and 2.0 wide drug compartment) was inserted as a precaution.

Bottom Line: We describe a case of a 67-year-old Caucasian woman with an early, moderately-differentiated adenocarcinoma of the endometrium.A levonorgestrel-releasing intrauterine system was inserted, which she tolerated well.Examination after 24 months showed a very thin endometrium, indicating complete remission.

View Article: PubMed Central - PubMed

Affiliation: Gynecological Outpatient Clinic and Training Center, Rooseveltlaan 43/44, 9000 Ghent, Belgium.

ABSTRACT
We describe a case of a 67-year-old Caucasian woman with an early, moderately-differentiated adenocarcinoma of the endometrium. A levonorgestrel-releasing intrauterine system was inserted, which she tolerated well. A full D&C, following removal of the device, was performed after 9 months, confirming absence of tumoral tissue. Examination after 24 months showed a very thin endometrium, indicating complete remission.

No MeSH data available.


Related in: MedlinePlus