Intermittent vaginal bleeding

A 39 year old female presented with intermittent vaginal bleeding. She complains of irregular menstruation for 2-3 months. She has to use pads in between her menstruation periods. She also complains of cough for 8 months. She has 3 children. All pregnancies were uncomplicated and the children born with normal delivery. All children are healthy. She is not on any contraceptives. Vitals are stable and she looks healthy. Little bleeding from the cervix was noted on examination. The rest of the examination was normal. TVS was done which shows an intrauterine mass. Beta hCG level is 420,000 mIU/ml. What are your comments on the case with keeping her both complaints in mind, Vaginal bleeding and cough.

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TVS suggest intrauterine mass Beta hcg is increased Agreed with dr Nisha Bhargava this is likely choriocarcinoma and need t be confirmed 2nd complaints of cough needs to be evaluated xray chest is needed Corelating with h/o bleeding p/v and tvs findings needs to r/o tuberculosis
Thanx dr Ashok Leel
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Pap smear, punch biopsy from bleeding of cervix, and fractional currattage of uterus is required to finalize the diagnosis. As there is no history of vesicular mole, Endometrial carcinoma should be on priority
* UTERINE PATHOLOGY ** X RAY AND FURTHER INVESTIGATION AND EVALUATION CAN CONCLUDE. GIVE SYMPTOMATIC TREATMENT TILL REPORTS COMPLIED. REASSURANCE AND COUNCILING REQUIRED.
Thanks Dr Vipin Bihari Jain
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IT'S A..CASE OF.. ? UTERINE PATHOLOGY.. ? MALIGNANCY.. NEED'S.. SCANNING..WITH EXPERTS OPINION TO CONCLUDE DIAGNOSIS AND TREATMENT..
Tnx Dr Vipin Bihari Jain
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Adv Xray chest. CBC with ESR Most likely choriocarcinoma. MRI pelvis Further management acc to report.
Seems to be uterine pathology ... commonest is Endometrial CA. Rule out GU TB.
Do X-ray chest MRI USG DEPENDING on report surgery or chemotherapy
For cough,need of p/A view chest,C/S SPUTUM,AFB,
Beautiful case presentation mam
Looks like choriocarcinoma
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