Twee postmenopauzale vrouwen met vaginaal bloedverlies door niet-gynaecologische maligniteiten

- A gynaecological examination was performed because of vaginal bleeding in a 67-year-old woman who was admitted for dyspnoea and a painful cough. A tumour was detected in the vaginal wall that turned out to be a metastasis of a locally extensive and metastasised Grawitz tumour. In a 76-year-old woman who presented with vaginal bleeding, speculum examination revealed a polyp that protruded from the cervix. A non-Hodgkin lymphoma was demonstrated histopathologically. In both patients, the cervical smear showed Pap-1. Both patients were given palliative treatment. According to the guidelines, the policy of general practitioners and gynaecologists in cases of postmenopausal blood loss should be directed primarily at the exclusion of malignancy by means of transvaginal echoscopy. However, some abnormalities may then be missed. A complete gynaecological examination then becomes very important. Speculum examination forms an essential part of such a work-up.

Ned Tijdschr Geneeskd. 2005;149:2649-52