Differential diagnosis for these appearances are endometrial cancer vs endometrial hyperplasia.

Endometrial hyperplasia was felt more likely given patient age, lack of predisposing factors and fact that she was seen by gynecologist a few months prior to presentation.

The patient was urgently referred to gynecology and biopsy confirmed suspected endometrial adenocarcinoma.

Endometrial carcinoma is most common in postmenopausal women. However it is also seen pre menopause especially in women with predisposing factors such as obesity, diabetes or on hormonal treatment of breast cancer.

In this case patient was premenopausal and had no predisposing factors

Main differential of endometrial carcinoma includes endometrial hyperplasia.