A 55-year-old postmenopausal woman with bilateral ovarian masses, CA-125 of 480 U/mL, and omental caking on CT undergoes staging. Intraoperatively, disease is found on the pelvic peritoneum, retroperitoneal nodes, and the right hemidiaphragm with a 2.5 cm deposit. The FIGO 2014 stage is:
- A Stage IIIA1 — positive retroperitoneal lymph nodes only
- B Stage IIIC — macroscopic peritoneal metastasis >2 cm beyond pelvis with retroperitoneal node involvement ✓
- C Stage IIIB — macroscopic peritoneal metastasis ≤2 cm beyond pelvis
- D Stage IVB — distant organ metastasis
Correct answer: B. Stage IIIC — macroscopic peritoneal metastasis >2 cm beyond pelvis with retroperitoneal node involvement
Explanation
Per FIGO 2014 staging for ovarian cancer, Stage IIIC is defined by macroscopic peritoneal metastasis beyond the pelvis measuring more than 2 cm, with or without retroperitoneal lymph node involvement. The diaphragmatic deposit of 2.5 cm qualifies as >2 cm peritoneal disease beyond the pelvis. Stage IVA would be pleural effusion with positive cytology; Stage IVB involves parenchymal organ metastasis (liver, spleen parenchyma, extra-abdominal nodes). Diaphragmatic peritoneal involvement is still Stage III.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.