This case involves a fifty-nine-year-old female patient who presented to her gynecologist complaining of abnormal vaginal bleeding that usually occurred after sexual intercourse. The patient also reported some vaginal discomfort, malodorous discharge, and painful urination. The physician said that her symptoms were likely due to vaginal atrophy and suggested that she use water-based lubricants before intercourse to prevent tearing and the associated bleeding. The patient did not receive a vaginal exam, ultrasound, or any other diagnostic testing during the visit. Four months later, the patient was admitted to the hospital for severe leg edema, pelvic pain, and acute kidney failure. The physician on her case suggested that the triad of symptoms pointed to a possible malignancy, with pelvic wall involvement. Upon further workup, it was revealed that the patient had invasive cervical cancer with distant metastasis, which included positive extra, pelvic lymph nodes that spread to the liver, lung, and bone. Her prognosis was considered to be very poor and she was referred for palliative measures.
