FIGO 2018 revised cervical cancer staging now incorporates imaging and pathological findings. A 40-year-old with cervical carcinoma has a parametrial mass on MRI and CT reveals a 2 cm right external iliac lymph node. Under FIGO 2018, she is classified as stage:

• A IIB — parametrial invasion
• B IIIB — pelvic side wall involvement
• C IVA — bladder or rectal mucosal involvement
• D IIIC1r — regional lymph node involvement detected by imaging ✓

Explanation

FIGO 2018 introduced stage IIIC, subdivided as IIIC1 (pelvic lymph node involvement) and IIIC2 (para-aortic lymph node involvement), with suffix 'r' for imaging-based detection and 'p' for pathological detection. Parametrial invasion alone is IIB, but the 2 cm external iliac lymph node on CT upgrades her to IIIC1r. This represents the major paradigm shift of 2018 FIGO staging — lymph node status can now upstage a tumour regardless of local extent.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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