Endometrial adenocarcinoma following supracervical hysterectomy managed with radiation due to dabigatran etexilate.

BACKGROUND

Dabigatran etexilate, a new oral anticoagulant, has been developed for use in atrial fibrillation. This medication does not require therapeutic monitoring and there is no reversal agent in the event of life-threatening bleeding. We present a case of vaginal hemorrhage because of endometrial adenocarcinoma after a supracervical hysterectomy in a patient using dabigatran.

CASE: 74-year-old woman status after supracervical hysterectomy presented with profuse vaginal bleeding. Biopsy confirmed high-grade adenocarcinoma, suggesting endometrial origin. Because of recent use of dabigatran and vaginal bleeding she underwent treatment with full-dose radiation and brachytherapy.

CONCLUSION

Adenocarcinoma following supracervical hysterectomy is a rare occurrence. In the presence of profuse bleeding because of an anticoagulant with no reversal agents and extended activity, alternate modalities may be used.