Cervical cancer Quiz: Ace Your Exams
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A 35-year-old woman comes to the office because of back pain. For the past four months, she has felt progressive colicky pain in the left lumbar region, which does not alleviate with medication. She endorses pain during sexual intercourse with her husband. She has no urinary symptoms. Her last menstrual period was three weeks ago. She has a history of essential hypertension and migraines. She currently takes propranolol for both conditions. Her mother died of breast cancer at 60-years-old. Vital signs are within normal limits. Physical examination shows a soft abdomen that is tender to deep palpation in the left lower quadrant. Lumbar percussion shows mild tenderness. Pelvic examination shows tenderness in the posterior vaginal fornix. Pap smear shows high grade squamous intraepithelial lesions. Urinalysis shows no abnormalities. Renal ultrasound is obtained and results are as follows:

Which of the following best explains the patient’s overall clinical presentation?

Which of the following best explains the patient’s overall clinical presentation?
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