1 / 27

A COMMON TUMOR AT AN UNCOMMON SITE

A COMMON TUMOR AT AN UNCOMMON SITE. Case Presentation By Dr. Mariam Zahir Post Graduate Trainee Department Of Obstetrics and Gynaecology Benazir Bhutto Hospital. PATIENT PROFILE. Mrs. XYZ 50 years female No formal education House wife Divorced for the last 14 years

rcassel
Download Presentation

A COMMON TUMOR AT AN UNCOMMON SITE

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. A COMMON TUMOR AT AN UNCOMMON SITE Case Presentation By Dr. MariamZahir Post Graduate Trainee Department Of Obstetrics and Gynaecology Benazir Bhutto Hospital

  2. PATIENT PROFILE • Mrs. XYZ • 50 years female • No formal education • House wife • Divorced for the last 14 years • Resident of Attock • Date of Admission: 11-8-16 • Mode of Admission: OPD

  3. PRESENTING COMPLAINTS • Swelling over the vulval region for last 10 years • Postmenopausal bleeding for last 1 month

  4. HISTORY OF PRESENT ILLNESS • The patient was in her usual state of health when she started noticing a mass at introitus 10 years back. • Initially it was small then gradually increased in size. • There were no associated urinary and bowel complaints. • History of post menopausal bleeding for last one month.

  5. GYNAECOLOGICAL HISTORY • Menarche : 12 years • Menstrual cycle: Previous cycle 7/28 days, regular, average blood flow. • No history of dysmenorrhea , dyspareunia, postcoital bleeding or intermenstrual bleeding • Never practiced any contraception.

  6. GYNAECOLOGICAL HISTORY Cont…. • No history of PAP smear • Menopause: 2 years back at the age of 48 years. • Post menopausal bleeding: 1 month

  7. OBSTETRICAL HISTORY • Patient is P4+1 • All uneventful spontaneous vaginal deliveries at home. • One son and three daughters. • Last child birth 21 years back. • Last miscarriage 15 years back followed by ERPC.

  8. Past Medical History: Not significant • Past Surgical History: Not significant • Family History: No history of breast, colon and ovarian malignancy • Drug History: No history of anticoagulant intake or HRT • Systemic Inquiry: Non-significant

  9. GENERAL PHYSICAL EXAMINATION • A lady of average built well oriented in time and space. • Vital signs: • Pulse : 88/min • BP : 110/70 mm Hg • Temp: 98.6 o F • Respiratory rate: 16/min

  10. GENERAL PHYSICAL EXAMINATION Cont... • Pallor : -ve • Weight: 48 Kg • Height : 155 cm • BMI: 20 Kg/m2

  11. SYSTEMIC EXAMINATION • ABDOMINAL EXAMINATION: Soft non tender, no mass palpable • CARDIOVASCULAR SYSTEM: Normal heart sounds, No added sounds. • RESPIRATORY SYSTEM: Normal vesicular breathing. • CENTRAL NERVOUS SYSTEM: Grossly intact

  12. LOCAL EXAMINATION

  13. INVESTIGATIONS

  14. ULTRASOUND OF MASS • A hypoechoic solid mass measuring 6 x 8cm with no calcifications. • Peripheral area more echogenic than central relatively anechoic area

  15. TRANSVAGINAL ULTRASOUND • Uterus 6x4x3.5 cm • Endometrial echo 4 mm • Bilateral adenexa normal

  16. For further evaluation Examination Under Anesthesia and Cystoscopy was planned.

  17. EXAMINATION UNDER ANESTHESIA(EUA) • A 6 X 8 cm firm mass at introitus. • A 4x5 cm ulcer at the most dependent part. Ulcer

  18. EXAMINATION UNDER ANESTHESIA(EUA)

  19. EXAMINATION UNDER ANESTHESIA(EUA)

  20. EXAMINATION UNDER ANESTHESIA(EUA) SPECULUM EXAMINATION : • Cervix normal looking. • Vagina normal looking and free of mass. • PAP smear taken. BIMANUAL EXAMINATION: • Uterus 6 week size, mobile with bilateral adenexa clear Normal Cervix

  21. EXAMINATION UNDER ANESTHESIA(EUA) • Urethra deviated to 2 o’ clock position. • Patient was catheterized to ascertain path of urethra

  22. CYSTOSCOPY • Date: 22 October,2016 • Surgeon : Prof. Dr. Mumtaz assisted by Dr Zeeshan • Findings:. Urethral opening was normal. Bladder was trabeculated. No communication of mass into urethra and bladder seen.

  23. CYSTOSCOPY VIDEO

  24. MICTURATING CYSTOURETHROGRAM Left Oblique View: Urethra deviated towards left side.

  25. MRI PELVIS

  26. MRI PELVIS

  27. TREATMENT Excision and enucleation of the mass was planned.

More Related