Ciebiera Michał, Słabuszewska-Jóźwiak Aneta, Ledowicz Witold, Jakiel Grzegorz
First Department of Gynaecology and Obstetrics, The Medical Centre of Postgraduate Education, Warsaw, Poland.
Prz Menopauzalny. 2015 Sep;14(3):208-10. doi: 10.5114/pm.2015.54348. Epub 2015 Sep 30.
We present a case report of a 73-year-old, postmenopausal woman with detailed history of breast cancer and oncology treatment including tamoxifen therapy. She presented at the clinic of gynecology and obstetrics with recurrent inflammation of the urinary and genital tract and suspicion of a cervical mass. She also presented occasional abdominal complaints and malodorous vaginal discharge. These symptoms were observed in the patient for several years. Before hospitalization she received many kinds of empirical, antimicrobial treatment such as chlorquinaldol, metronidazole, nifuratel, and nystatin. She did not receive further guidance from doctors about the causes of ailments and further diagnostic and treatment capabilities. In our clinic a detailed diagnostic process including ultrasound transvaginal examination and a minisurgical procedure revealed the presence of a vaginal foreign body (which turned out to be a plastic, shampoo bottle cap) surrounded by a mass of inflamed tissue mimicking a cervical tumor. All symptoms and complaints subsided after surgical removal of the foreign body and antibacterial therapy with metronidazole and cefuroxime. Our study draws attention to the need of thorough gynecological care including prophylaxis, especially in the case of complaints of an intimate nature. Even trivial, frequently occurring disorders can be dangerous and require proper and responsible doctor's supervision and management through the healing process.
我们报告一例73岁绝经后女性的病例,该患者有详细的乳腺癌病史及肿瘤治疗史,包括他莫昔芬治疗。她因泌尿生殖道反复炎症及疑似宫颈肿物就诊于妇产科门诊。她还偶尔出现腹部不适及有异味的阴道分泌物。这些症状在患者身上已持续数年。住院前,她接受了多种经验性抗菌治疗,如氯喹那多、甲硝唑、硝呋太尔和制霉菌素。她未从医生处获得关于疾病病因及进一步诊断和治疗的指导。在我们诊所,详细的诊断过程包括经阴道超声检查和一个小型手术,结果发现有一个阴道异物(原来是一个塑料洗发水瓶盖),其周围是一团炎症组织,形似宫颈肿瘤。手术取出异物并使用甲硝唑和头孢呋辛进行抗菌治疗后,所有症状和不适均消失。我们的研究提醒人们注意全面的妇科护理的必要性,包括预防措施,尤其是对于涉及隐私的不适症状。即使是轻微的、经常出现的病症也可能很危险,在整个治疗过程中需要医生进行适当且负责的监督和管理。