STUDENT PROBLEM-BASED LEARNING SESSION
A 48 year old G3P3 woman comes to the office for a health maintenance exam. She has no concerns. She is in good health. She had three normal vaginal deliveries and underwent a tubal ligation after the birth of her third child 15 years ago. She has no history of abnormal Pap smears or sexually transmitted diseases. Her cycles are regular and her last menstrual period was 18 days ago. She is not taking any medications. Her family history is significant for a maternal aunt who was diagnosed with ovarian cancer at age 60. On examination, she has normal vital signs. Her heart, lungs and abdominal exams are normal. On pelvic examination, she has normal external genitalia, normal vagina and cervix. On bimanual exam, she has a slightly enlarged uterus and a palpable right adnexal mass which is confirmed on the vagino-rectal exam.
Adnexal masses are a common finding in both symptomatic and asymptomatic patients. Management is based on determining the origin and character of these masses.
The APGO Educational Objectives related to this topic are the following:
*Designated as Priority One in the APGO Medical Student Educational Objectives, 8 th Edition