19th April 2022

A 55-year-old woman presents to her GP with symptoms of weight loss

A 55-year-old woman presents to her GP with symptoms of weight loss, irregular vaginal bleeding and discomfort, and dysuria. She has no previous medical history, and has not been attending cervical screening for the past 10 years as she has travelled frequently for her job.
On speculum examination, you notice a white scaly lesion on the vaginal wall that appears firm and nodular. It is located on the anterior aspect of the wall.

Given the likely diagnosis, what would be the most appropriate initial investigation?

Select the SINGLE most appropriate option from the list below. Select ONE option only.