The confidential interview
Introduction Adolescence is a complex developmental phase with cognitive, physical, and psychosocial milestones ( Table 2.1 ). As a young person navigates this journey, they may engage in risk-taking behaviors…
Pediatric and adolescent well-child examination/preventive care
Introduction The American Academy of Pediatrics (AAP) developed the primary care medical home as a model of delivering primary care with the goal of addressing and integrating high-quality health promotion,…
Vulvovaginal melanoma
Clinical case A 44-year-old nulliparous female presents with vaginal discharge. A vaginal tumor is biopsied, revealing invasive melanoma. On physical exam, there is a 5 cm polypoid and mostly hypopigmented…
Gestational trophoblastic disease
Clinical case A 32-year-old G1P0 at 9 weeks and 3 days gestational age by last menstrual period presents with new onset vaginal bleeding. A transvaginal ultrasound shows no embryo, but…
Bartholin gland carcinomas
Clinical case A 62-year-old woman presents to her general gynecologist with a complaint of right-sided vulvar itching and discomfort over the past 2 months. She is an otherwise healthy person…
Other rare vulvovaginal cancers: Verrucous carcinoma, aggressive angiomyxoma, vulvar yolk sac tumor
Clinical case A 38-year-old woman presents to her general gynecologist with a complaint of a vaginal “cyst” at the introitus. She notes some fullness at the opening to the vagina…
Vulvar extramammary Paget disease
Clinical case A 72-year-old patient presents with a 6-month history of vulvar pruritus and irritation. She has tried multiple antifungal medications with no improvement. On physical examination, she has an…
Clear cell carcinoma of the vagina and cervix
Clinical case A 29-year-old G2P2 woman with a known bicornuate uterus presents to the office with irregular vaginal bleeding. A pelvic exam demonstrates a 2 cm friable lesion on the…
Other rare cervical cancers: cervical rhabdomyosarcoma, adenoid cystic carcinoma, verrucous carcinoma
Introduction The overwhelming majority of cervical cancer cases will be either squamous cell or adenocarcinoma. In a National Cancer Database (NCDB) study of cervical cancer in the United States, 79.5%…
High grade neuroendocrine carcinoma of the cervix
Clinical case A 32-year-old G0 female presents with a newly diagnosed small cell neuroendocrine carcinoma (NEC) of the cervix. On physical exam, she is noted to have a 1.5 cm…
