Endometrial Cancer

1. A 55-year-old postmenopausal patient with a BMI of 24 and two episode of postmenopausal bleeding presents to the clinic. She is otherwise asymptomatic. Abdominal and pelvic examination is unremarkable, and the endometrial thickness is 6 mm. An outpatient hysteroscopy and biopsy is arranged; the cavity is noted to be 7.5 cm in length and an adequate sample is taken. The endometrium was noted to be atrophic at hysteroscopy and the cavity normal. 2 weeks later, the histology report reads “some inactive endometrium but sample insufficient for diagnostic purposes”.

2. 60 year old with BMI 38, is postmenopausal since 10 years. Has history of 2 episodes of postmenopausal bleeding. TVS followed by endometrial where copious amount of endometrium was obtained on histopathological examination shows endometrial cancer. MRI was done and it showed Endometrial cancer localised to endometrium and not invading myometrium. No lymph node involvement noted on MRI. What is the stage of cancer?

3. 60 year old with BMI 38, is postmenopausal since 10 years. Has history of 2 episodes of postmenopausal bleeding. TVS followed by endometrial biopsy where copious amount of endometrium was obtained on histopathological examination shows endometrial cancer. MRI was done and it showed Endometrial cancer localised to endometrium and not invading myometrium, No lymph node involvement notes on MRI. Stage 1 is suspected after MRI. What is best treatment for this patient?

4. You have to explain principal role of radiotherapy in the treatment of endometrial cancer to your juniors. Which is the most appropriate of the following?

5. Which of the following increases the risk of endometrial cancer?

6. Oral contraceptive pills reduce the risk of endometrial cancer by: