<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 62-year-old woman presents to the clinic for postmenopausal bleeding for the past month. She reports that the bleeding often occurs after intercourse with her husband. The patient denies fever, weight loss, chills, chest pain, abdominal pain, or shortness of breath but endorses mild dyspareunia and vaginal discharge. Her past medical history is significant for human papilloma virus and cervical cancer that was treated with surgical resection and radiation 5 years ago. Physical examination is unremarkable except for an irregular mass protruding from the vaginal wall. What is the most likely explanation for this patients condition?? A: Atrophy of vaginal tissues secondary to old age, B: Metastasis of cervical cancer via direct extension, C: Metastasis of cervical cancer via hematogenous spread, D: Primary malignancy of vaginal squamous cells, E: Primary malignancy of endometrial cells,  <response>: This is a patient with a history of cervical cancer 5 years ago that was treated with surgery and radiation. She now presents with postmenopausal bleeding and a vaginal mass. The key findings are:- Postmenopausal bleeding - History of cervical cancer- Vaginal mass- Mild dyspareunia and dischargeThe postmenopausal bleeding and vaginal mass are concerning for recurrence of cancer. Given her history of cervical cancer, the most likely explanation is metastasis of the original cervical cancer. Choice B of metastasis of cervical cancer via direct extension is most consistent with the clinical presentation.Choice A of atrophy is less likely in a postmenopausal bleeding presentation. Choices D and E of new primary vaginal or endometrial cancers are less likely than recurrence of known cervical cancer. Choice C of hematogenous spread is less likely than direct extension for cervical cancer metastasis.B: Metastasis of cervical cancer via direct extension 