A 60-year-old woman comes to the office for evaluation of postmenopausal bleeding

Medicoman · March 19, 2020, 11:00am

A 60-year-old woman comes to the office for evaluation of postmenopausal bleeding The patient went through menopause at age 53

and did not use menopausal hormone therapy Four months ago, she noticed some postcoital bleeding that resolved within a day.

For the last 3 months, the patient has had daily vagina1 spotting and sometimes has bleeding similar to the first day of her menstrual

cycle She has obstructive sleep apnea and hyperlipidemia. Pap test last year was normal. The patient does not use tobacco,

alcohol, or illicit drugs. Blood pressure is 130/80 mm Hg and pulse is 68/min. BMI is 34 kg/m2 The abdomen is soft and nontender.

Speculum examination shows a small amount of blood in the vaginal vault and a normal cervix. Bimanual examination reveals right

adnexal fullness and a slightly enlarged uterus. Hemoglobin is 11.8 g/dL Pelvic ultrasound shows an 11-cm solid ovarian mass and

no free fluid in the pelvis Endometrial biopsy shows complex hyperplasia without atypia Which of the following is the most likely

diagnosis in this patient?

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