Two cases of unusual presentation of hormonal levonorgestrel intrauterine system - Mirena®
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2021.169347Keywords:
Intrauterine devices, Endometrial neoplasms, Contraceptive agents, Case reports, LevonorgestrelAbstract
ABSTRACT: Intrauterine contraceptives containing levonorgestrel, Mirena®, widely used in contemporary gynecology as an effective method of contraception and control of menstrual disorders, have shown to reduce rates of endometrial cancer. In addition, complications such as perforation and migration are rare, requiring rapid intervention. Description: Two atypical cases about the use of intrauterine hormonal device, the first deals with migration of the device to the abdominal cavity, after 1 year and 8 months of insertion, without perforation, with videolaparoscopic withdrawal. The second is a case of primary endometrial cancer in a patient with 3 years of use of Mirena®. Discussion: Migration of the intrauterine device is a rare complication, little reported in the literature, the videolaparoscopic approach is the preferred one and was performed in the case in question. The hormonal intrauterine device is also related to the decreased rates of endometrial cancer and is also used as a preventive method in high-risk women. After reviewing the literature, only six similar cases were described. Conclusion: The intrauterine hormonal device, although safe, may imply rare presentations, such as migration and perforation, which require knowledge and agility of the professional team. The second case presented is a rare event, which makes it aware for women with an unusual hemorrhagic pattern to use Mirena®.
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Copyright (c) 2021 José Juvenal Linhares, Dr., Clara dos Santos Queiroz, Francisco de Assis e Silva, Micaele Esloane Soares, José Urbano de Medeiros Neto, Pedro Gomes Cavalcante Neto
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