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Abstract
Mrs. X, 66 years of age, Para1, presented to us on 1st March 2021, with complaints of severe postmenopausal bleeding over the last 1 month. She had multiple co-morbidities like poorly controlled type 2 diabetes, chronic kidney disease, hypertension and hypercholesterolemia. She had been having milder bleeding episodes previously from November 2020, but evaluation was postponed due to an acute episode of stroke in December 2020.
She was on two anti-platelet medications at the time of her presentation in March 2021. She was found to have pelvic organ prolapse (POP-Q grade 3 with large cystocele and posterior compartment defects) along with increased postmenopausal bleeding at the time of presentation. Her Hb was 7gm% and her HbA1c of 7.6% also needed correction. She underwent hysteroscopy and endometrial biopsy, which revealed a 3x3 cm submucosal endometrial growth (Figure 1).
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References
- Liang W, Guan W, Chen R, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol 2020;21(3):335-7.
- Nepogodiev D, Bhangu A, Glasbey JC, et al. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet 2020;396(10243):27-38.
- Grass F, Behm KT, Duchalais E, et al. Impact of delay to surgery on survival in stage I-III colon cancer. Eur J Surg Oncol 2020;46(3):455-61.
- Uwins C, Bhandoria GP, Shylasree TS, et al. COVID-19 and gynecological cancer: a review of the published guidelines. Int J Gynecol Cancer 2020;30(9):1424-33.
- Martinelli F, Garbi A. Change in practice in gynecologic oncology during the COVID-19 pandemic: a social media survey. Int J Gynecol Cancer 2020;30(8):1101-7.
- Bogani G, Brusadelli C, Guerrisi R, et al. Gynecologic oncology at the time of COVID-19 outbreak. J Gynecol Oncol 2020;31(4):e72.
- Concin N, Matias-Guiu X, Vergote I, et al. ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma. Int J Gynecol Cancer 2021;31(1):12-39.
- Wortman BG, Creutzberg CL, Putter H, et al. Ten-year results of the PORTEC-2 trial for high-intermediate risk endometrial carcinoma: improving patient selection for adjuvant therapy. Br J Cancer 2018;119(9):1067-74.
- Barney BM, Petersen IA, Mariani A, et al. The role of vaginal brachytherapy in the treatment of surgical stage I papillary serous or clear cell endometrial cancer. Int J Radiat Oncol Biol Phys 2013;85(1):109-15.
References
Liang W, Guan W, Chen R, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol 2020;21(3):335-7.
Nepogodiev D, Bhangu A, Glasbey JC, et al. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet 2020;396(10243):27-38.
Grass F, Behm KT, Duchalais E, et al. Impact of delay to surgery on survival in stage I-III colon cancer. Eur J Surg Oncol 2020;46(3):455-61.
Uwins C, Bhandoria GP, Shylasree TS, et al. COVID-19 and gynecological cancer: a review of the published guidelines. Int J Gynecol Cancer 2020;30(9):1424-33.
Martinelli F, Garbi A. Change in practice in gynecologic oncology during the COVID-19 pandemic: a social media survey. Int J Gynecol Cancer 2020;30(8):1101-7.
Bogani G, Brusadelli C, Guerrisi R, et al. Gynecologic oncology at the time of COVID-19 outbreak. J Gynecol Oncol 2020;31(4):e72.
Concin N, Matias-Guiu X, Vergote I, et al. ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma. Int J Gynecol Cancer 2021;31(1):12-39.
Wortman BG, Creutzberg CL, Putter H, et al. Ten-year results of the PORTEC-2 trial for high-intermediate risk endometrial carcinoma: improving patient selection for adjuvant therapy. Br J Cancer 2018;119(9):1067-74.
Barney BM, Petersen IA, Mariani A, et al. The role of vaginal brachytherapy in the treatment of surgical stage I papillary serous or clear cell endometrial cancer. Int J Radiat Oncol Biol Phys 2013;85(1):109-15.