A 48-year-old woman who had documented ovarian endometriosis for years now has a large complex left adnexal mass. Histopathology of the resected tumour shows sheets of large clear cells and hobnail cells lining gland-like spaces. Among epithelial ovarian cancers confined to the ovary (Stage I), this histotype carries which distinction?

• A Best prognosis due to platinum sensitivity
• B Highest frequency of bilaterality
• C Relatively poorer prognosis owing to chemoresistance ✓
• D Uniformly indolent behaviour identical to borderline tumours

Explanation

Clear cell carcinoma arises from endometriotic epithelium in a substantial proportion of cases, shows clear and hobnail cells, and behaves aggressively despite often being diagnosed at Stage I because it is relatively resistant to platinum-based chemotherapy. High-grade serous carcinoma, not clear cell, is the type most likely to be bilateral at presentation, so option B fails.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.