Tumor necrosis observed after uterine artery embolization for bleeding control in a woman with suspected endometrial cancer: a case report

Uterine artery embolization (UAE) is commonly performed for benign uterine diseases and as a palliative treatment for bleeding associated with gynecologic malignancies. However, its role in suspected early-stage endometrial cancer remains unclear. A 46-year-old nulliparous woman presented with severe abnormal uterine bleeding after endometrial biopsy. Imaging revealed a large intrauterine mass with active bleeding; there was also significant anemia. UAE was performed for hemostasis prior to definitive diagnosis. Post-procedural magnetic resonance imaging showed the absence of tumor enhancement. One month later, the patient underwent total hysterectomy with staging surgery. Pathological examination demonstrated complete tumor necrosis, with no viable tumor cells. The patient was diagnosed with stage IA endometrial carcinoma and received adjuvant chemotherapy. No recurrence was observed over 18 months of follow-up. Although a direct causal relationship cannot be established, this case highlights the potential role of UAE for temporary bleeding control and the importance of obtaining tissue diagnosis before embolization when malignancy is suspected. • Uterine artery embolization achieved temporary bleeding control in a woman with suspected endometrial cancer. • Complete tumor necrosis was observed after uterine artery embolization. • Embolization may complicate the pathological assessment of uterine malignancy. • Adequate tissue diagnosis should be obtained before embolization whenever possible.