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133thInterinstitue conference Gynecologic Oncology Department , National Cancer Institue
. Patient
identification A 52 year-old Thai woman Occupation :Agriculture Payment :Universal
coverage scheme Hometown :Kanchanaburi Chief
complaint Palpable vulvar mass 6 months PTA Present
illness 6 months PTA , she felt tense and palpated indurated mass at right
side of vulva. The mass size was about 1 cm. and it proceeded in size. She
refused to see doctor because of embarrassing. 1 moth PTA , She could not sit in normal position due to press on
the mass. She came to NCI for her underlying cervical cancer surveillance. She had no abnormal vaginal bleeding or discharge , no pelvic pain
. No weight loss , Normal appetite Past
history 2007 :Diagnosis
: squamous cell carcinoma of cervix stage IB1 :Treatment : RHND BSO : Post operative adjuvant CCRT ( Metastatic left pelvic LN ) : Continuous surveillance ( last time :1 year PTA : normal ) No
history of DM , HT No
history of food and drug allergy Obstetrics
and Gynecologic history G3P3 last 29 years Surgical menopause Family
history No history of cancer in her family Physical
examination BW 54 kg. HT 158 cm. BMI 21.6 kg/m2 V/S :BT 370C PR 68 /min RR 20 /min BP 119/74
mmHg HEENT : Not pale ,
No jaundice , No SCLN enlargement Heart & Lung. : No
murmur, Normal breath sound Breast : No
palpable abnormal mass Abdomen : Soft, no
tenderness , no palpable mass : Impalpable liver and spleen Groin LN : No
enlargement Pelvic
examination MIUB / vagina A firm consistency , dark gray mass 5x3x1.5 cm. at Rt labia minora
, extended to urethral orifice , anterior vaginal wall and vaginal vault and 2
cm distance from anal verge No palpable pelvic mass RV examination :Smooth rectal mucosa Tumor extended from both paravaginal tissue to pelvic wall No mass above vaginal stump Discussion :What
is a provisional diagnosis and investigation? :What are proper managements? |
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