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Dr. Andrew Rynne

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Abnormal vaginal bleeding with pain. Found bulky uterus and ovary. Endometrial or cervical cancer?

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Dr. Manjunath L Ramarajapalli

OBGYN, Gynecologic Oncology

Practicing since :1984

Answered : 99 Questions

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Posted on Mon, 4 Feb 2013 in Head Injuries
Question: Hi I have been having bleeding daily with pain that comes and goes. An ultrasound one month ago when all this started showed a normal uterus size and all looke good except for some free fluid near one ovary and behind my uterus...I was told this is normal and probably the result of a follicle rupture. Blood tests showed two inflammatory markers were up. I know one is CRP but cant remember the other one. I recently had a diagnostic laparoscopy at the same time of umbilical hernia repair. The surgeon noted a very bulky uterus and ovary high up in abdomen. Since I have seen my GP for a referral to my gynecologist, the GP did a thin prep test which I'm waiting for results. She found something on cervix sorry cant remember name but it's when bit of endometrium sits on outside of cervix. I take XXXXXXX 35Ed daily. She couldnt complete XXXXXXX examination as I was in way too much pain and there was too much blood. She has stated on referral painful intercourse as well as couldn't palpate fornices not sure what this means. My mum has had stage 1 endometrial cancer burnt off neck of uterus in past. Does this sound like endometrial or cervical cancer or could it be something else?
doctor
Answered by Dr. Manjunath L Ramarajapalli 2 hours later
Hello,

Your GP probably saw a bit of endometrium sits on cervix. Probably this is endometriosis.

Endometriosis is known to give rise to pain and post coital bleeding/spotting.

Fornices can be palpated/examined under anesthesia, if required.

Endometrial and cervical cancers should be ruled out by diagnostic D & C/cervical biopsy.
Thin Prep (pap) test is screening test to rule out cervical cancer.

Discuss about these options with your treating doctor. Let me know if you have more queries.

Good luck.

Above answer was peer-reviewed by : Dr. Shanthi.E
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Follow up: Dr. Manjunath L Ramarajapalli 1 hour later
If it is endometriosis shouldn't the surgeon who did the diagnostic laparoscopy eyeball this during the operation? He only noticed a very enlarged and bulky uterus. He did say he didn't see any endometriosis but could he have missed it?
doctor
Answered by Dr. Manjunath L Ramarajapalli 37 minutes later
Hello,

Endometriosis is the presence of endometrial tissue other than in the normal place (uterus).
This may be the endometriosis of the cervix. Probably there was no abdominal endometriosis when laparoscopy was done.

Hope this clarifies.

Above answer was peer-reviewed by : Dr. Shanthi.E
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Follow up: Dr. Manjunath L Ramarajapalli 29 minutes later
Ok just to clarify my referral says ectropion present. Could this still mean what your saying?
doctor
Answered by Dr. Manjunath L Ramarajapalli 41 minutes later
Hello,

No, ectropion is everted cervical lips. This is clinical diagnosis, not pathological.

Regards,
Above answer was peer-reviewed by : Dr. Shanthi.E
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