title: Endometrial adenocarcinoma following the insertion of a Mirena IUCD.
abstract: BACKGROUND
  The case histories of two patients who developed endometrial adenocarcinoma with a Mirena intrauterine system (IUS) in place are reported.
  
  
  METHODS
  Two patients had a Mirena IUS inserted to treat abnormal vaginal bleeding. After 12 and 36 months with the device in place they presented with a recurrence of their heavy, irregular menstrual bleeding. Endometrial biopsies confirmed the presence of endometrial adenocarcinoma, and hysterectomies were performed. In one patient the cancer was localized and below the stem of the device, in the other metastatic disease had developed.
  
  
  CONCLUSIONS
  These cases raises important issues regarding the use of the Mirena IUS to treat menorrhagia.
authors.affiliation: Ashford and St. Peter's Hospital, London Road, Middlesex, TW15 3AA, United Kingdom.
authors.forename: Kevin
authors.initials: K
authors.lastname: Jones
authors.forename: Mel
authors.initials: M
authors.lastname: Georgiou
authors.forename: Derek
authors.initials: D
authors.lastname: Hyatt
authors.forename: Tim
authors.initials: T
authors.lastname: Spencer
authors.forename: Hilary
authors.initials: H
authors.lastname: Thomas
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology*; D016889:Endometrial Neoplasms / Q000209:etiology*; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects*; D016912:Levonorgestrel / Q000008:administration & dosage / Q000009:adverse effects*; D008595:Menorrhagia / Q000188:drug therapy / Q000628:therapy; D008875:Middle Aged
chemical_list: D016912:Levonorgestrel