Cervical cancer in 2 women with a Mirena®-pitfalls in the assessment of irregular bleeding: a case series
1 Department of Obstetrics & Gynaecology, Albert Schweitzer Hospital, Dordrecht, The Netherlands
2 Laboratory for Pathology, Dordrecht, The Netherlands
Cases Journal 2008, 1:62 doi:10.1186/1757-1626-1-62Published: 26 July 2008
The levonorgestrel-releasing intra-uterine device (Mirena®) is an effective, long term form of contraception that leads to a significant reduction of menstrual bleeding among majority of women. However, irregular bleeding is quite common in initial Mirena® users and may thereby mask underlying cervical pathology.
Two women with cervical cancer and a Mirena® initially presented with irregular bleeding, posing a diagnostic pitfall which resulted in doctor and patient delay.
Proper evaluation of irregular vaginal bleeding, including cervical cytology, should be a prerequisite among all women opting for a Mirena® and must be repeated in case of persisting symptoms.