CASE PRESENTATION
A 46-year P3+1L3 regularly menstruating presented with a complaint of excessive per vaginal bleeding during the menstrual cycle for the past one and a half years. She used 4-5 pads/day, fully soaked with the passage of clots without dysmenorrhea. There was no history of intermenstrual bleed, post-coital bleed, and dyspareunia. Also, there was no other illness and no history of malignancy in the family.
On examination, she had a BMI of 25.2 kg/m2 and her vitals were normal. Per abdominal examination was unremarkable. Per speculum examination revealed a healthy cervix with a bloodstain. On per vaginal examination, there was a left adnexal mass around 6cm x 5cm, firm to solid cystic, smooth, mobile, and non-tender with the groove felt between the mass and uterus. With the suspicion of an ovarian mass, routine investigations along with tumor markers were sent. (Table 1)
Table 1: Routine investigation and Tumor markers