Vaginal bleeding!
Chief Complaint A 70 yo female presents with the complaint of slight genital bleeding & pain. History She has 2 children, both healthy. Hysterectomy was done 20 years back for myoma Examination Pelvic examination shows a 4 cm firm tumor on posterior vaginal wall, which was the probable cause for bleeding. Treatment What next should be done?
As there is 4 cm firm vaginal tumor and at the Age of 70 likely provisional diagnosis 1) vault malignancy 2) rectal growth3) ovarian growth if not remove during surgery.4) in absence of firm growth senile vaginitis may be cause but not in this case. Treatment take biopsy from growth. If malignant then oncology consultation required.
Think of senile vaginitis first Next DD malignancy of vaginal vault Advise CA125, histopathology of discharge
Tumour posterior vaginal wall. Exclude rectal malignancy invading the post vaginal wall by DRE Do a biopsy of the mass posterior vaginal wall Enquire weather patient had undergone salphingo oophrectomy along with Hysterectomy Bilateral/ unilateral
Biopsy and histopathological examination will clinch dx. Benign nature-surgical removable only with conservative tt. Malignant nature-surglcal intervention with radiotherapy.
DD,senile vaginitis hv.pap smear with Histopathology study
Histopathology is needed of vaginal vault tumour
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