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

Q1. A 55-year-old woman is referred to rapid access clinic (gynaecological oncology) for PMB. An ultrasound scan reveals thickened endometrium and a solid ovarian mass on the left side. An endometrial Pipelle biopsy shows grade 1 endometrioid carcinoma. She undergoes TAH+BSO. Her Ca125 (150 units/mL) and inhibin B levels (100 ng/L) are elevated. She undergoes staging laparotomy (TAH+BSO, omentectomy, peritoneal biopsies and peritoneal washings and look around inside the abdomen).What would be the likely histological diagnosis of ovarian mass in her case?

Q2. A 20-year-old woman presents to GP with abdominal distension. She is referred to rapid access clinic (gynaecological oncology). Her Ca125 is 100, CEA, AFP, ß-HCG, LDH are normal. CT scan reveals a large solid mass arising from the left ovary with normal right ovary. She undergoes staging laparotomy with fertility preservation. The histology reveals immature grade 2 neural tissue. What is the histological diagnosis in this case?

Q3. A patient is noted to have symmetrical bilateral ovarian tumours which are removed. The histopathology report reveals tumour cells show signet ring morphology and raise the possibility that these represent metastasis rather than primary ovarian malignancy. Which is the most likely primary site?

Q4. A 24-year-old woman presents to her GP with abdominal pain. Clinical  examination reveals a large abdomino-pelvic mass. She is referred to a rapid access 2-week wait clinic. Following investigations, computed tomography (CT) scan reveals left-sided solid ovarian mass with raised serum lactate dehydrogenase (LDH) enzyme levels. She undergoes fertility sparing surgery  and the histology reveals nests of tumour cells (vesicular cells with clear cytoplasm and central nuclei) separated by fibrous stroma infiltrated with T lymphocytes.  Which is the most likely type of ovarian tumour in her case?

Q5. A 40-year-old woman para 2 presents with bloating and abdominal swelling. Her mother died of ovarian cancer and her sister died of breast cancer at the ages of 50 and 40, respectively. A genetic screening test reveals that she is carrier of BRCA1 gene. Her management include the following except for which of the following?

Q6. A 45-year-old woman presents to GP with abdominal bloating. A blood test was performed for Ca125 which measures 1000 units/mL. She is referred to rapid access clinic (gynaecological oncology). A CT scan (chest, abdomen and pelvis) reveals a large abdominal mass possibly filled with mucin. The findings are suggestive of mucinous carcinoma. She undergoes staging laparotomy which reveals pre-operative rupture of the cyst with ascites and mucinous substance filling the abdomen. The histology is reported as mucinous carcinoma of the left ovary with rupture of cyst. What is the International Federation of Gynecology and Obstetrics (FIGO)

stage in her case?

Q7  . All of the following statements regarding borderline ovarian tumors are true except:

Q8 . During surgery for ovarian tumor, if the frozen section report is a borderline ovarian tumor, which of the following is not a recommended procedure?

Q9.The following statements are true regarding borderline ovarian tumors except:

Q10. Borderline tumors of the ovary are commonly associated with the following genetic mutation:

Q 11. The most common cause of death from gynaecological malignancy in the developed world:

Q 12. Call–Exner bodies are found in:

Q13. Ms. XY is 64 years old, postmenopausal. Her recent TV ultrasound scan reveals the presence of a 4 cm right ovarian cyst. The cyst is multiloculated and shows the presence of a solid area. There is no free fluid. The left ovary is normal. Her CA125 is 50 u/ml. She has been explained of her RMI results. What is her RMI score based on the information provided?