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Progestin intrauterine device in an adolescent with grade 2 endometrial cancer
Alaina J Brown1, Shannon N Westin, Russell R Broaddus
1From the Department of Gynecology and Obstetrics, the Johns Hopkins Medical Institutions, Baltimore, Maryland; and the Departments of Gynecologic Oncology and Pathology, the University of Texas MD Anderson Cancer Center, Houston, Texas.
Background:
The treatment of endometrial cancer in young women who desire future fertility poses several challenges. Oral progestin and progestin-releasing intrauterine devices (IUDs) have been shown to result in regression of endometrial hyperplasia and grade 1 endometrioid endometrial carcinoma. However, limited data are available on the use of these methods in women with grade 2 disease.
Case:
An 18-year-old nulliparous woman was diagnosed with a grade 2 endometrial adenocarcinoma. She desired future fertility and therefore underwent placement of a levonorgestrel-releasing IUD. The patient subsequently underwent endometrial sampling every 3 months and remained disease-free 13 months after initial IUD placement.
Conclusion:
A progestin-releasing IUD may be a valid treatment option for grade 2 endometrial cancer in young women who desire to retain fertility.
