A 68-year-old postmenopausal obese (BMI 34) woman presents with postmenopausal bleeding. Endometrial biopsy shows endometrioid adenocarcinoma, Grade 2. MRI pelvis shows tumour invading >50% of myometrial thickness with no cervical extension or parametrial invasion. CT shows no distant metastasis. Retroperitoneal lymph nodes are negative on imaging. FIGO 2023 stage is:
- A Stage IB ✓
- B Stage IA
- C Stage II
- D Stage IIIA
Correct answer: A. Stage IB
Explanation
FIGO 2023 endometrial carcinoma staging: Stage IA = no or less than half myometrial invasion; Stage IB = invasion ≥50% myometrium, confined to corpus. The tumour invades >50% myometrium (Stage IB) with no cervical stromal invasion (which would make it Stage II), no adnexal/parametrial spread (IIIA), and no distant metastasis. Stage IB Grade 2 endometrioid carcinoma is managed with total hysterectomy, bilateral salpingo-oophorectomy, and sentinel lymph node assessment; adjuvant vaginal brachytherapy is often recommended.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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