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 Postmenopausal bleeding  



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Author5 Posts
  #1

A 65 yrsold woman who had menopause at 50 yrs of age, is the mother of two kids which she had in her twenties. She presents to your office with Vaginal bleeding for 10 days. PE shows enlarged uterus.Ultrasound shows a large uterus with an abnormal endometrial mass 5 * 6 * 11 cms.

Whats the differential diagnoses and further evaluations required?





  #2

Endometrial biopsy----> if cancer is found----------> endometrial cancer----------->hysterectomy included surgical removal of cervix

CT scan to look for enlarged LN------->peri-aortic, retro-peritoneal LN etc and staging of the cancer

DDX-----> endometrial cancer, peri-menopausal withdrawl bleeding------> luteal phase deficiency---------->Factor V leiden deficiency------------->Von Wille factor deficiency----------->pregnancy---------->(A British doctor 63 years old just got pregnant)------------> missed abortion



  #3

What is the role of MRI in this patient prior to biopsy?


  #4

NO ROLE FIRST STEP IS ENDMETRIAL SAMPLING PREFERABLY BY PIPELLE METHOD WHICH CAN B DONE IN OUT PATIENT AND PREFERED METHOD NOW.


  #5

endometrial aspiration in conjunction with hysteroscopy is the next step but MRI may be done if biopsy specimen shows endometrial CA, to determine extent of disease.





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