Review Question - QID 210494

A 29-year-old woman presents to her primary care physician with vaginal discharge. The patient states that for the past month she has experienced a worsening malodorous vaginal discharge and bleeding after sexual intercourse. The patient has a past medical history of polycystic ovarian syndrome and is currently taking metformin. She was recently worked up for infertility by her obstetrician. Results of one of her studies is seen in Figure A. Her temperature is 99.5°F (37.5°C), blood pressure is 137/78 mmHg, pulse is 90/min, respirations are 17/min, and oxygen saturation is 98% on room air. Physical exam demonstrates an irregular mass in the vagina and coarse hair over the patient's upper lip. Which of the following is the most likely diagnosis?