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

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.