Key points 1. Adenocarcinoma of the endometrium is the most common gynecologic malignancy, with both rising incidence and mortality. 2. Classically, endometrial cancer is divided into two histologic types: type I is endometrioid, and type II consists of uterine serous…
Introduction The endometrium is a dynamic tissue in reproductive age women. It is continuously cycling in response to hormonal, stromal, and vascular influences, with the ultimate goal of implanting an embryo and supporting the nutritional needs of the developing pregnancy.…
Key points 1. Conservative management of early-stage cervical cancer in young women should be considered if childbearing is important to that patient. 2. In many developing countries, cervical cancer is the leading cause of cancer death in young women. 3.…
Key points 1. Vaccination for human papilloma virus (HPV) should decrease the incidence of high-grade squamous intraepithelial lesions (HSILs) of the vulva and vagina. 2. Lichen sclerosus is associated with vulvar cancer. 3. If there is any concern for malignancy,…
Key points 1. Persistent expression of human papillomavirus (HPV) is required for progression to cancer. 2. HPV vaccination has the potential to eradicate cervical cancer. 3. Screening guidelines have changed dramatically with the use of contesting and increased intervals between…
Clinical case A 32-year-old G1P0 at 9 weeks and 3 days gestational age by last menstrual period presents with new onset vaginal bleeding. A transvaginal ultrasound shows no embryo, but notes a complex, echogenic intrauterine mass containing many small cystic…
Clinical case A 38-year-old woman presents to her general gynecologist with a complaint of a vaginal “cyst” at the introitus. She notes some fullness at the opening to the vagina and feels that this interferes with penetrative intercourse. She denies…
Clinical case A 72-year-old patient presents with a 6-month history of vulvar pruritus and irritation. She has tried multiple antifungal medications with no improvement. On physical examination, she has an erythematous plaque-like rash involving the perineum and bilateral labia majora…
Clinical case A 62-year-old woman presents to her general gynecologist with a complaint of right-sided vulvar itching and discomfort over the past 2 months. She is an otherwise healthy person who receives age-appropriate, routine health maintenance, and screening. She notes…
Clinical case A 44-year-old nulliparous female presents with vaginal discharge. A vaginal tumor is biopsied, revealing invasive melanoma. On physical exam, there is a 5 cm polypoid and mostly hypopigmented lesion with a broad base arising from the right lateral…