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<p>We present a case highlighting the importance of monitoring patients with leiomyoma degeneration undergoing long-term local hormonal therapy using a levonorgestrel-releasing intrauterine system (LNG-IUS). Retrospective ultrasonographic observations over 7&#xa0;years revealed sequential changes in a mass at the exact location, allowing early detection of malignancy. Histological examination confirmed that malignant leiomyosarcoma cells have replaced benign smooth muscle cells. This finding underscores the need for advised monitoring of LNG-IUS users, particularly in patients with leiomyoma degeneration changes. Further research is warranted to investigate the potential association between prolonged use of LNG-IUS and the development of leiomyosarcoma. To our knowledge, this is the first reported case of leiomyosarcoma arising during the insertion of an LNG-IUS.</p>

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A case of leiomyosarcoma during long-term levonorgestrel intrauterine system (LNG-IUS) insertion

  • 期刊论文

  • 发表日期：

    2025年11月8日

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  • Yoko Suzuki,
  • Kenji Kuroda,
  • Hiroko Nakagami,
  • Ken Kuriki,
  • Hiromitsu Shinohara,
  • Kazutoshi Naritaka

摘要

We present a case highlighting the importance of monitoring patients with leiomyoma degeneration undergoing long-term local hormonal therapy using a levonorgestrel-releasing intrauterine system (LNG-IUS). Retrospective ultrasonographic observations over 7 years revealed sequential changes in a mass at the exact location, allowing early detection of malignancy. Histological examination confirmed that malignant leiomyosarcoma cells have replaced benign smooth muscle cells. This finding underscores the need for advised monitoring of LNG-IUS users, particularly in patients with leiomyoma degeneration changes. Further research is warranted to investigate the potential association between prolonged use of LNG-IUS and the development of leiomyosarcoma. To our knowledge, this is the first reported case of leiomyosarcoma arising during the insertion of an LNG-IUS.