A 64-year-old postmenopausal woman with a BMI of 38, type 2 diabetes, and hypertension presents with postmenopausal bleeding. Transvaginal ultrasound shows endometrial thickness of 14 mm. Endometrial biopsy confirms endometrioid adenocarcinoma. MRI shows tumour confined to the uterus with >50% myometrial invasion but no cervical involvement. The FIGO 2023 stage is:

• A Stage IA
• B Stage II
• C Stage IIIC1
• D Stage IB ✓

Explanation

Under FIGO 2023 staging for endometrial carcinoma: Stage IA is tumour confined to the uterus with <50% myometrial invasion; Stage IB is tumour confined to the uterus with ≥50% myometrial invasion. This patient has >50% myometrial invasion with no extrauterine spread, which is Stage IB. Stage II requires cervical stromal invasion. Stage IIIC1 indicates pelvic lymph node metastases. The 2023 revision of FIGO staging incorporates molecular classification but the anatomical stage for this case remains IB.

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

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