Abnormal vaginal bleeding in women with gynaecological malignancies

Best Pract Res Clin Obstet Gynaecol. 2017 Apr:40:134-147. doi: 10.1016/j.bpobgyn.2016.09.014. Epub 2016 Oct 26.


Abnormal vaginal bleeding is a common gynaecological symptom, and most causes are benign. International Federation of Gynaecology and Obstetrics proposed a PALM-COEIN classification in 2011 to decrease heterogeneity in studies. The gynaecological malignancies that present with abnormal bleeding vary according to the age of the patient and the origin (upper versus lower genital tract). It is important that a thorough history and examination is performed to make this distinction. The common malignancies presenting symptoms and treatment are discussed in this article according to the age of the patient. There is a considerable overlap between the reproductive age and menopause. This article focuses on children, adolescents and women in the reproductive age group.

Keywords: cervical cancer; fertility sparing; inequity in care; torrential bleeding management.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma, Clear Cell / complications
  • Adenocarcinoma, Clear Cell / diagnosis
  • Adenocarcinoma, Clear Cell / therapy
  • Adolescent
  • Adult
  • Child
  • Diagnosis, Differential
  • Female
  • Genital Neoplasms, Female / complications*
  • Genital Neoplasms, Female / diagnosis
  • Genital Neoplasms, Female / therapy
  • Gestational Trophoblastic Disease / complications
  • Gestational Trophoblastic Disease / diagnosis
  • Gestational Trophoblastic Disease / therapy
  • Humans
  • Neoplasms, Germ Cell and Embryonal / complications
  • Neoplasms, Germ Cell and Embryonal / diagnosis
  • Neoplasms, Germ Cell and Embryonal / therapy
  • Ovarian Neoplasms / complications
  • Ovarian Neoplasms / diagnosis
  • Ovarian Neoplasms / therapy
  • Pregnancy
  • Rhabdomyosarcoma / complications
  • Rhabdomyosarcoma / diagnosis
  • Rhabdomyosarcoma / therapy
  • Sex Cord-Gonadal Stromal Tumors / complications
  • Sex Cord-Gonadal Stromal Tumors / diagnosis
  • Sex Cord-Gonadal Stromal Tumors / therapy
  • Uterine Hemorrhage / etiology*
  • Uterine Hemorrhage / therapy
  • Young Adult