Thrombotic microangiopathy following a minor gynaecological
• Unexpected hemorrhage followed diagnostic hysteroscopy dilatation and curettage.

• Thrombotic microangiopathy occurred in the context of stage 1 endometrial cancer.

• Minor gynecological surgery resulted in the development of thrombotic microangiopathy.

Hysteroscopy dilatation and curettage is a common minor gynecological procedure utilized for diagnostic or therapeutic purposes. A 62-year-old woman underwent a hysteroscopy, dilatation, and curettage for investigation of prolonged post-menopausal bleeding. An unexpected uterine hemorrhage was encountered without evidence of uterine perforation causing hemodynamic instability. Thrombotic microangiopathy was triggered, leading to microangiopathic haemolytic anemia, thrombocytopenia, and evidence of micro-thrombosis causing stroke and end-organ dysfunction, including acute renal failure. The histopathology confirmed stage 1 endometrioid adenocarcinoma. This is the first case report of thrombotic microangiopathy leading to microangiopathic hemolytic anemia in a patient with endometrioid adenocarcinoma FIGO grade 1, stage 1B following a minor gynecological procedure.