The diagnosis in this case is an endometrial polyp. To understand why, let's analyze the condition and the options given:
An endometrial polyp is a mass in the inner lining of the uterus, the endometrium. It is common in women over 40 and can lead to symptoms such as irregular menstrual bleeding or spotting, particularly in postmenopausal women. In this scenario, a 60-year-old female experiencing intermittent bleeding suggests an abnormality in the endometrial cavity.
To differentiate the options:
Endometrial Polyp: Typically presents as a hyper-echoic or iso-echoic mass within the endometrial cavity on ultrasound. It may appear as a focal, sessile or pedunculated mass projecting into the uterus, consistent with the case's symptoms of bleeding.
Ca Endometrium (Endometrial Cancer): Often associated with thicker, irregular endometrial lining rather than a distinct mass like a polyp. Symptoms include postmenopausal bleeding, but ultrasound findings might show diffuse endometrial thickening rather than a focal lesion.
Submucosal Fibroid: A fibroid growing into the uterine cavity can also cause abnormal bleeding. On ultrasound, it typically appears as a round, well-defined, hypo-echoic mass and can lead to distortion of the endometrial cavity.
Given the symptoms and common presentation on ultrasound, the most likely diagnosis for a 60-year-old female with intermittent bleeding, where the ultrasound shows a localized mass projecting into the endometrial canal, is an endometrial polyp. Other conditions like endometrial carcinoma and submucosal fibroids have distinct presentations that are less likely given the patient profile and symptoms.
