Vaginal dryness and dyspareunia.

59 year old female complaining about vaginal dryness and dyspareunia. She reported a total hysterectomy at age 42 due to uterine fibromyoma and also a rectal cancer at age 56 treated with chemo-radiotherapy. During her gynaecological examination, a painless flat dark and soft lesion with a maximum diameter of 2 cm was found, located at the middle 1/3 of the posterior wall of the vagina. the bimanual examination was pain free and no other abnormality was registered. At the digital rectal examination, no rectal tumors were found. Can you tell the diagnosis?

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Painful intercourse with itching with bluish discolouration of the post wall of vulva suggestive of vulvar melanoma Biopsy is needed for confirmation and treatment.

An isolated vaginal secondary metastasis needs to be ruled out . An excision biosy needs to be done to rule out secondary and even if it is a benign lesion

Pt has history of rectal carcinoma This is a painless lesion...it could be a metastatic lesion Biopsy should be done to rule out malignancy

Senile vaginitis . Previous history of malignancy so do biopsy if required. Rx use lubricant. Avoid intercourse up to healing.

It may be metastatic of existing or previous melignency. Biopsy is advised..thru coloscopy.

Senile vaginitis Evalon cream can be given Biopsy of lesion can be done

Colposcopy to be done with biopsy Suspected melanoma

May be Vaginal melanoma need biopsy to confirm

This can be vulval melanoma ..biopsy needed

Senile vaginitis lubricant is required

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