Postmenopausal Vaginal Bleeding with Cystic Endometrial Changes: A Case Report

Abstract

Postmenopausal bleeding (PMB) is a common gynecological complaint requiring prompt assessment due to the potential risk of underlying pathology such as endometrial hyperplasia or malignancy. We present a case report of a 58-year-old postmenopausal woman with a six-month history of moderate to severe vaginal bleeding. Gynecological imaging, including ultrasound and MRI pelvis, revealed a thickened, heterogeneous endometrium with internal cystic spaces, raising suspicion for an endometrial polyp or neoplasia. Pre-operative laboratory evaluation showed mild normocytic anemia and a slightly elevated BUN level, but no signs of infection or systemic illness. Based on clinical findings and risk stratification, the patient underwent hysterectomy with bilateral salpingo-oophorectomy. Histopathological examination of the excised specimen revealed adenomyosis and chronic cervicitis, with no evidence of malignancy. This case highlights the importance of early detection and appropriate surgical intervention in patients with postmenopausal bleeding to rule out serious pathology and guide effective management.