The first doctor advises no surgery at present and diagnosed the mass as a fibroid. Pap smears have been negative. The second gynecologist advises surgery, beginning with a laparoscopy and likely progressing to a hysterectomy. The woman has other health issues that make any kind of surgery a serious risk. Fibroids do not generally develop or even grow after menopause, and if this mass was not present until 2.5 years ago I'd be a bit concerned about a uterine sarcoma, although an MRI scan may be helpful in this area.
Fibroids can persist after menopause, particularly if they are calcified.
Again, an MRI may be useful in supporting or refuting that diagnosis. If it is a fibroid, and there are no significant symptoms it is often best to leave it alone, particularly if the patient is at high risk for any surgery. Another opinion can't hurt, in my judgment. It varies, depending on the study, and hysterectomy is a last resort in these cases. The problem with many studies is that it is hard to distinguish between recurrence of endometriosis and persistent disease.