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What Causes Post Menopausal Bleeding, Anaemia, Hypertension, Back And Lower Abdomen Pain?
Question: Please offer opinion.
General symptoms…
64 year-old Female.
Two episodes of post menopausal bleeding, Back pain, lower abdomen pain, history of anaeamia and hypertension.
Recent blood test showed elevated liver enzymes
Please see consultant radiologist report…
Ultrasound of pelvis including transvaginal ultrasound
Endometrial cavity appears distended by a nodular area measuring 1.7 x 1.8cm. Mildly heterogeneous echogenicity with no definite internal vascularity. Small free fluid within the lower endometrial cavity. There may be some normal endometrial tissue evident displaced posteriorly.
Retroverted uterus measures 6. 9 x 3.7 x 5cm
Right ovarian volume 4.2 ml. 2.3 cm simple appearing cyst right ovary. Left ovarian volume 1.10
ml
Right kidney measures 9.3 cm. Left Kidney measures 10.8 cm. Normal corticomedullary
differentiation seen bilaterally and no hydronephrosis. Bladder appears normal
Increased liver echogenicity in keeping with steatosis
Impression:
Abnormal thickening- filling defect in the endometrial cavity. An endometrial polyp or submucosal fibroids would be considerations. Suggest gynecology opinion.
Simple right adnexal cyst
General symptoms…
64 year-old Female.
Two episodes of post menopausal bleeding, Back pain, lower abdomen pain, history of anaeamia and hypertension.
Recent blood test showed elevated liver enzymes
Please see consultant radiologist report…
Ultrasound of pelvis including transvaginal ultrasound
Endometrial cavity appears distended by a nodular area measuring 1.7 x 1.8cm. Mildly heterogeneous echogenicity with no definite internal vascularity. Small free fluid within the lower endometrial cavity. There may be some normal endometrial tissue evident displaced posteriorly.
Retroverted uterus measures 6. 9 x 3.7 x 5cm
Right ovarian volume 4.2 ml. 2.3 cm simple appearing cyst right ovary. Left ovarian volume 1.10
ml
Right kidney measures 9.3 cm. Left Kidney measures 10.8 cm. Normal corticomedullary
differentiation seen bilaterally and no hydronephrosis. Bladder appears normal
Increased liver echogenicity in keeping with steatosis
Impression:
Abnormal thickening- filling defect in the endometrial cavity. An endometrial polyp or submucosal fibroids would be considerations. Suggest gynecology opinion.
Simple right adnexal cyst
Brief Answer:
Your patient needs an endometrial biopsy and a D+C/Hysteroscopy
Detailed Answer:
Hello I hope I can help you today.
Postmenopausal bleeding always needs a GYN evaluation because it is the presenting symptom in most cases of endometrial cancer.
This patient's ultrasound is most suggestive of an endometrial polyp. Polyps are mostly benign, but can contain cancer.
The rest of the ultrasound findings are normal.
I recommend your patient first have an endometrial biopsy to see if there is any evidence of cancer on the specimen. This is performed by a gynecologist. If the biopsy shows cancer, the patient will need a total hysterectomy so referral to a GYN oncologist would be appropriate. If the biopsy looks benign, the patient should need a D+C preferably with a Hysteroscopy. This is also performed by a GYN surgeon.
I hope my interpretation and recommendations are helpful to you and that O answered your question. Please do not hesitate to contact me further of you need clarification or have any further questions.
Your patient needs an endometrial biopsy and a D+C/Hysteroscopy
Detailed Answer:
Hello I hope I can help you today.
Postmenopausal bleeding always needs a GYN evaluation because it is the presenting symptom in most cases of endometrial cancer.
This patient's ultrasound is most suggestive of an endometrial polyp. Polyps are mostly benign, but can contain cancer.
The rest of the ultrasound findings are normal.
I recommend your patient first have an endometrial biopsy to see if there is any evidence of cancer on the specimen. This is performed by a gynecologist. If the biopsy shows cancer, the patient will need a total hysterectomy so referral to a GYN oncologist would be appropriate. If the biopsy looks benign, the patient should need a D+C preferably with a Hysteroscopy. This is also performed by a GYN surgeon.
I hope my interpretation and recommendations are helpful to you and that O answered your question. Please do not hesitate to contact me further of you need clarification or have any further questions.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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