Question

47 y/oG3P3 several month history of progressive abdominal bloating. Had regular menses entire life, but recently bleeding heavier and 2x/month. Normal weight, GI: some abd distension, Pelvic: non enlarged, deviated uterus, 10 cm mobile nontender right adnexal mass. Office endometrial biopsy: complex endometrial hyperplasia w/o atypia. What is the adnexal mass?

Answer 1

The described symptoms and endometrial biopsy results suggest the likelihood of an ovarian mass, possibly related to endometriosis or benign ovarian cysts, necessitating further diagnostic testing.

Step-by-step explanation:

The patient described has a history of progressive abdominal bloating, increased frequency and volume of menstrual bleeding, and a non-tender adnexal mass detected during a pelvic exam. Given the endometrial biopsy results showing complex endometrial hyperplasia without atypia, and the presence of a 10 cm mobile, nontender mass in the adnexal area, a likely diagnosis is an ovarian mass.

However, without more diagnostic imaging such as an ultrasound or MRI, it's difficult to definitively identify the mass. Considering the possibility of gynecological conditions such as endometriosis, benign ovarian cysts, or other ovarian masses, further testing and evaluation by a specialist is necessary to assess the nature of the adnexal mass.

The adnexal mass described in the patient's case is a nontender right adnexal mass. Adnexal refers to the structures adjacent to the uterus, including the ovaries and fallopian tubes. A nontender mass indicates that it is not causing any discomfort or pain.