A 49-year-old G4P4 (4004) comes to your outpatient department because of bloatedness and abdominal enlargement for the past six months. LMP was two months back. She denies urinary nor bowel disturbances. Pelvic mass is palpated at the midline, movable and nontender, approximately measures 10 cms. Can I know the impression?
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G4, you mean she is pregnant? Rule out pregnancy. Have a urine pregnancy test, you never know. Amenorrhea may be due to perimenopausal status. Mass can be a fibroid, adenomyosis, ovarian mass in the midline. Nongynecological cause like rectus divarication and bowel hernia, mesenteric cyst, mass in the bowel.
You will need to examine per speculum and manually to confirm and finally a scan to localize the mass. Since it is mobile and no other complaints, should be a benign cause.
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