A 43 y/o female who came because of a sudden genital passage of a heterogeneous mass (45 × 58 mm resembling a gestational sac, with the shape of the uterine cavity) during the expected time for menstrual bleeding. The patient had had 5 previous pregnancies with 5 term vaginal deliveries, she had been previously submitted to female laparoscopic tubal ligation, she had no relevant past medical records or chronic medication and had regular menses. For more than 5 years she had not been under any hormonal medication. What is it?

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Menstrual blood, passed as clot. She is in peri menopausal age. Still rule out pregnancy by UPT/beta HCG. Send the clot/mass for histopath.
Endometrial cast
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May be a case of missed abortion. Sent the specimen for Histopathology to make diagnosis.
UPT should be done .if negative, then it is normal endometrium shed off enmass. .
Nice case.