A 38-year-old woman presents with painless post-coital bleeding. She had a cone biopsy for carcinoma in situ five years ago. Her last pap smear was three months after the biopsy. Her last period was six weeks ago. Most probable diagnosis is: (A) Carcinoma of cervix, (B) Ectopic pregnancy, (C) Endometrial carcinoma, (D) Uterine fibroids
Answer is A. The recurrence of abnormal vaginal bleeding in a patient with a previous history of a cone biopsy would raise concerns of carcinoma of the cervix.Her last smear was nearly five years ago, indicating she defaulted from follow-up after her cone biopsy.Six weeks amenorrhoea might raise concerns about an ectopic pregnancy but the absence of pain makes this unlikely.It would always be wise to perform a pregnancy test and scan if in any about.