EBCOG Part 1 Oncology – Day 3 EMQ

a.Stg 1A

Bstg 1B

c.Stg 1C

d.Stg II

e.Stg IIA

f.Stg IIB

g.Stg IIIA

h.Stg IIIB

i.Stg IIIC1

j.Stg IIIC2

k.Stg IVA

l.Stg IVB

choose the most appropriate FIGO stage for endometrial cancer from the list of options above. each option maybe used once ,more than once or not at all.

1. 60 year old woman presents with post menopausal bleeding to the gynecology oncology clinic .An endometrial pipelle biopsy reveals an endometrioid adenocarcinoma .she's further investigated with a magnetic resonance imaging scan which reveals uterine  myometrial invasion of less than 50% and enlarged pelvic nodes .She subsequently undergoes a total abdominal hysterectomy ,bilateral salpingoophorectomy and Sentinel lymph node biopsy .You review her in the clinic at 2 weeks follow up with the Histology report of endometrial cancer with myometrial invasion of more than 50% and pelvic lymph node involvement .

2. A 44 year old woman presents to the emergency department with heavy vaginal bleeding and intermenstrual bleeding for the last 6 months .Following a gynecology review a hysteroscopy and endometrial biopsy were arranged .2 weeks after her hysteroscopy she attends the gynaecology oncology clinic and the histology reveals a papillary serous carcinoma .A computed tomography scan of the chest is reported as normal while the MRI scan reveals a large uterine tumour infiltrating the serosal surface of the uterus and also involving the pelvic nodes .Subsequently she undergoes a total abdominal hysterectomy ,bilateral salpingo-oophorectomy and pelvic lymphadenectomy in an oncology center.The final Histology confirms the MRI findings

3.An 82 year old woman presents to the emergency department with post menopausal bleeding and her hemoglobin is 7 g/dl .She receives 2 units of blood transfusion and undergoes hysteroscopy and an endometrial biopsy on an emergency basis ,as she continued to bleed heavily .Endometrial biopsy reveals clear cell carcinoma .She subsequently undergoes a total abdominal hysterectomy ,bilateral salpingo-oophorectomy and pelvic lymphadenectomy .The histology reveals clear cell carcinoma involving the uterine cervix and serosal surface .

4. 55 year old woman is referred to the rapid access clinic with post menopausal bleeding .She returns to the clinic for her pipelle biopsy result which reveals endometrial cancer .She then undergoes a total abdominal hysterectomy and bilateral salpingo-oophorectomy .The final histology reveals tumour infiltration of less than 50% of the myometrium and involvement of the cervical stroma .Also peritoneal washings are reported to be positive for malignant cells

5.58 year old woman attends the rapid access clinic with post menopausal bleeding ,following which she has outpatient hysteroscopy and endometrial biopsy .The Histology revealed an endometrioid adenocarcinoma .She subsequently undergoes a total abdominal hysterectomy and bilateral salpingo-oophorectomy .The final histology is reported as endometrioid adenocarcinoma involving the endometrium and peritoneal washings were positive for malignant cells.