Facts, Views & Vision
in ObGyn

Journal of the European Society for Gynaecological Endoscopy

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Use of a frameless LNG-IUS as conservative treatment for a premalignant uterine polyp in a premenopausal woman – a case report

D. Janssens1, G. Verbeeck2, D. Wildemeersch3

1Gynaecologische Dienst, Turnhout, Belgium.

2Department of Anatomo-pathology, St. Elisabeth Hospital, Turnhout, Belgium.

3APCOR Research Unit, University of Ghent Technology Park, Ghent (Zwijnaarde), Belgium.

Correspondence at: Dirk RG Janssens, Steenweg op Zevendonk 46, 2300 Turnhout, Belgium. E-mail: drg.janssens@skynet.be

Keywords:

Atypical endometrial hyperplasia, conservative treatment, frameless IUS, levonorgestrel, LNG-IUS, premalignancy


Published online: Jan 11 2016

Abstract

Prevention of progression to invasive carcinoma in patients with a premalignant endometrial lesion using long-term treatment with levonorgestrel (LNG) releasing intrauterine systems (IUS) remains controversial, especially when manifest cellular atypia has been found in the endometrial biopsy specimen. We present a case of a 44-year old premenopausal woman with a premalignant uterine polyp who declined hysterectomy and was followed-up for more than 12 years after the first LNG-IUS was inserted. Endometrial atrophy installed, no pathology was detected and hysterectomy was thereby successfully avoided. The positive experience in this case should encourage further studies as literature data indicate that conservative treatment of premalignant endometrial pathology is a real option with a high success rate for women who have a contra-indication for surgery, refuse the classical approach for personal reasons or want to preserve their fertility.