EBCOG P1-3 months May 202-Oncology- Day 4

Options

A.Intra-peritoneal chemotherapy
B.External beam radiotherapy
C.Intracavitary radiotherapy
D.Combined chemo-radiotherapy
E.Systemic chemotherapy + interval cytoreductive surgery
F.Radiotherapy + interval cytoreductive surgery
G.No additional treatment
H.Palliative care
I.Immunotherapy
J.Intra-peritoneal radiotherapy
K.Systemic chemotherapy

For each scenario described below, choose the single most appropriate management.

Q1.A 47 yr old with complex ovarian mass has undergone staging laparotomy. Peritoneal washings are +ve for adenocarcinoma. Ihere was an omental cake with tumour deposits on diaphragmatic peritoneum. 'Ihe tumour was debulked with residual tumour deposits of 2-3cm. There is no evidence of distant or intra-hepatic metastases. Histology confirms a well differentiated endometroid adenocarcinoma.

Options

A.No further treatment

B.Adjuvant chemotherapy

C.External beam radiotherapy

D.Intracavitary radiotherapy

E.Intra-peritomeal chemotherapy

F.TAH + unilateral salpingo-oophrectomy

G.Unilateral salpingo-oophrectomy

H.Monthly pelvic ultrasound scans

I.Monthly pelvic ultrasound scans + tumour markers

J.Ovarian stimulation + IVF

K.TAH

For each scenario described below, choose the single most appropriate management.

 

Q2. A 37 yr old with complex ovarian mass had staging laparotomy+ unilateral salpingo- oophorectomy to conserver fertility. Peritoneal washings, omentum, peritoneal biopsies are - ve. There is well differentiated endometroid adenocarcinoma confined to ovary & capsule is  not invaded. Biopsies from conserved ovary & lymph nodes are normal.

Q3. A 35 yr old with a complex ovarian mass had staging laparotomy with unilateral  salpingo-oophrectomy to conserver fertility. Peritoneal washings contain atypical  cells but  peritoneal biopsies are -ve. There is well differentiated endometroid adenocarcinoma  extending to the surface of ovary. Biopsies from conserved ovary & LN  are normal.

Option list for Questions

 A.Stage IA

B.Stage IB

C.Stage ICI

D.Stage IC2

E.Stage IC3

F.Stage IIA

G.Stage IIB

H.Stage IIIA1

I.Stage IIIA2

J.Stage IIIB

K.Stage IIIC

L.Stage IVA

M.Stage IVB

For each of the following cases, select the stage. Each option may be used once more than once or not at all.

Q4. An 80-year-old woman presents with a large pelvic mass. Imaging reveals liver metastasis and extensive peritoneal deposits with appearances suggestive of omental cake.

Q5. A 68-year-old woman presents with bilateral ovarian tumours but no evidence of spread elsewhere.

Q6. A 70-year-old woman presents with high-grade serous ovarian cancer extending! into uterus and fallopian tubes. No other pelvic organs are involved and there is no evidence of distant metastasis.

Q8. A 60-year-old woman presents with high-grade serous ovarian cancer extending into uterus and fallopian tubes. In addition, there are multiple peritoneal deposits > 2 cm in the upper abdomen with evidence of tumour on the surface/capsule of the spleen only.

Questions: EMQs

Option list for Questions  

 

 A.Brenner tumour

B.Choriocarcinoma

C.Clear cell tumour of ovary

D.Dysgerminoma

E.Endometriosis

F.Granulosa tumour

G.High-grade serous epithelial cancer

H.Leydig cell tumour

I.Mature cystic ovarian teratoma

J.Ovarian fibroma

K.Ovarian thecoma

For each of the following cases, select the single most likely diagnosis. Each option may be used once, more than once or not at all.

 

Q9. A 45-year-old woman undergoes a total laparoscopic hysterectomy and bilateral salpingo-oophorectomy for endometrial cancer. She has a body mass index of 20 and no relevant medical or family history. At the time of surgery her left ovary has a  distinct yellow appearance.

Q10. An 18-year-old woman with a pelvic mass arising from the right adnexa. Lactate dehydrogenase is markedly elevated.

Q11. A 48-year-old woman undergoes total laparoscopic hysterectomy and bilateral salpingo-oophorectomy as part of risk-reducing surgery for BRCA1 mutation. The histology of the ovaries shows occult malignancy.

Option list for Questions  

 A.0

B.10

C.40

D.85

E.90

F.140

G.255

H.315

I.700

J.2240

K.2310

L.4335

For each of the following cases, select the correct risk of malignancy index score. Each option may be used once, more than once or not at all.

 

Q12. A 64-year-old postmenopausal woman with bilateral with a left ovarian cyst measuring 4 cm and containing a single septation and a right simple cyst measuring 6 cm. Her CA-125 is 35 kU/L.

Q13. A 70-year-old women  has a complex 6 cm ovarian cyst with solid and liquid components and multiple septations. There is a small amount of free fluid. Her CA -125 is 10 KU/L