EBCOG P1-3 months May 202-Oncology- Day 5

Option list for Questions

 

A.Azathioprine

B.Canesten cream

C.Cyclosporine

D.Clobetasol cream

E.Imiquimod

F.Methotrexate

G.Moisturisers

H.Mycophenolate

I.Prednisolone

J.Reassurance and counselling to break the itch cycle

I.Wide local excision and groin node dissection

 

for each of the following cases, select the single most appropriate treatment. Each option may be used once, more than once or not at all.

 

1.A 70-year-old woman presents with a 3 cm squamous cell cancer on her cell cancer on her right labia

2.A 45-year-old woman presents with multicentric VIN.

Option list for Questions  

 

 A.Stage 0 vagina carcinoma

B.Stage I vaginal carcinoma

C.Stage Ia vulval cancer

D.Stage Ib vulval cancer

E.Sage II vaginal carcinoma

F.Stage II vulval cancer

G.Stage III vaginal carcinoma

H.Stage III vulval cancer

I.Stage IVa vaginal carcinoma

J.Stage IVa vulval cancer

K.Stage IVb vaginal carcinoma

L.Stage IVb vulval cancer

M.VAIN (vaginal intraepithelial neoplasia) I

N.VAIN II

O.VAIN III

P.VIN I

Q.VIN II

R.VIN III

Instructions: The following patients presented with symptoms of either vulval or vaginal malignancy. They were examined and ancillary investigations were undertaken prior to staging the disease. Select from the option list above the single most appropriate stage of the carcinoma. Each option may be selected once, more than once or not at all.

 

Q3. A 75-year-old woman presented with an ulcer on the vulva which was biopsied. This has been confirmed on histology to be carcinoma of the vulva confined to the vulva and with a maximum diameter of 1.5 cm.

Q4. An 82-year-old woman has just had an examination under anaesthesia and a biopsy of a suspicious lesion of the vulva. The lesion, which was confined to the left labium majorum, measured 3.5 cm. There were no palpable groin nodes. This has now been confirmed to be squamous carcinoma of the vulva.

Q5. A 78-year-old woman presents with a mass on the vulva which extends into the lower vagina. She has bilaterally enlarged groin nodes. A biopsy of the mass has confirmed it to be carcinoma of the vulva.

Options

A.Excisional biopsy

B.Exfoliative cytology

C.5- florouracil staining.

D.Iodine stain

E.Incisional biopsy

F.Three incision

G.Vulvul cytology

H.Radical excision

 

Q6. A 60-year-old woman presented with vulval itching and soreness of 3 months duration. She was examined and found to have a well-circumscribed raised whitish area on the left vulva. A tissue is taken that contains the interface between normal and abnormal epithelium and that is large enough for the pathologist to adequately provide evidence of substage (Stage I vulval carcinoma) is called?

Q7. A 74-year-old presents with a localized small area of redness on the right labium majus. There is no associated bleeding and it is not irritating. She is examined and found to have a well-circumscribed discrete superficial lesion measuring 1x1cm, which is thought to be vulval intraepithelial neoplasia with a low suspicion of invasive disease. There are no palpable lymph nodes. This lesion is removed under general anesthesia such that all the abnormal epithelium is included. It is malignant, but the tissue removed is needed to provide a tumor-free zone of 1 cm (after fixation) on all dimensions is called?

Q8. A gynecological oncologist removes a 2-cm lesion of the right labium marjoram from a 78-year-old woman who presented with pain and itching of 6months duration. Examination in the clinic has revealed a small pigmented swelling that measured 1.5 x 2 cm in diameter with no associated lymphadenopathy. Lesion is proved to be SCC on biopsy.  The removed lesion is complete with at least 2 cm (after fixation) on all sides is called?