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Re: Gyn: Postmenopausal Bleeding, part 2 From: Henry Gregor (henrygregor@yahoo.com) Thu Dec 29 20:14:00 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr Eberhard Lisse: "Re: Cesarean on Demand" Previous message: Henry Gregor: "Re: Piercing" In reply to: Garry E. Siegel, M.D.: "Gyn: Postmenopausal Bleeding, part 2" Hysto D&C sounds reasonable...would most likely give reassurance of a pretty firm diagnosis and might then lead to comfort with less invasive treatment, such as Depo or Megace. SInce she's developed this endometrium on combined HRT, would think atypia would be reasonable to suppress, with followup sampling, surgery if not effective. "Garry E. Siegel, M.D." <garrys@mindspring.com> wrote: 74 YO P0001 (1 adopted) on Vivelle 0.05 and Prometrium 100 mg./day presents with postmenopausal bleeding. The biopsy is complex hyperplasia with atypia, with a comment that there is not enough stroma to be certain there isn't a more advanced lesion. Would you: 1. Do and D and C and/or hysteroscopy? 2. Proceed to TAH-BSO? 3. Proceed to TAH-BSO and staging for endometrial cancer (which, for me, means involving a gyn oncologist)? 4. Proceed to TAH-BSO, get a frozen section, and then know whether staging is needed? I should add that the gyn oncology group doesn't really appreciate getting unplanned calls to step in for a node sampling, etc., when there was a chance to have pre-arranged. Garry -- Garry E. Siegel, M.D. Private Practice Roswell, GA Ring in the New Year with Photo Calendars. Add photos, events, holidays, whatever. Next message: Dr Eberhard Lisse: "Re: Cesarean on Demand" Previous message: Henry Gregor: "Re: Piercing" In reply to: Garry E. Siegel, M.D.: "Gyn: Postmenopausal Bleeding, part 2"

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