Gynaecological oncology: endometrial stromal sarcoma: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Gynaecological oncology: endometrial stromal sarcoma

Sample item

A 45-year-old woman has hysterectomy for a presumed fibroid, and histology shows low-grade endometrial stromal sarcoma with tongue-like myometrial invasion, positive for oestrogen and progesterone receptors. What additional therapy is considered?

AAnti-androgen therapyBPlatinum-based chemotherapy as first-lineCHormonal therapy such as aromatase inhibitors or progestinsDRadioiodine

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Hormonal therapy such as aromatase inhibitors or progestins

Low-grade endometrial stromal sarcoma is hormone receptor positive and indolent, with late recurrence, and responds to hormonal therapy such as progestins or aromatase inhibitors. Bilateral oophorectomy is usually performed. High-grade tumours behave aggressively and may need chemotherapy.

Option by option

A. Anti-androgen therapy
Anti-androgens are not used in this tumour.
B. Platinum-based chemotherapy as first-line
Chemotherapy is reserved for high-grade or progressive disease.
C. Hormonal therapy such as aromatase inhibitors or progestins (correct)
Correct. Receptor-positive low-grade disease responds to hormonal therapy.
D. Radioiodine
Radioiodine treats thyroid cancer.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Hormonal therapy such as aromatase inhibitors or progestins. Low-grade endometrial stromal sarcoma is hormone receptor positive and indolent, with late recurrence, and responds to hormonal therapy such as progestins or aromatase inhibitors.

Why is "Anti-androgen therapy" not the answer?

Anti-androgens are not used in this tumour.

Why is "Platinum-based chemotherapy as first-line" not the answer?

Chemotherapy is reserved for high-grade or progressive disease.

Why is "Radioiodine" not the answer?

Radioiodine treats thyroid cancer.

What concept does this question test?

It tests Gynaecological oncology: endometrial stromal sarcoma in OBG. Bilateral oophorectomy is usually performed. High-grade tumours behave aggressively and may need chemotherapy.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gynaecological oncology: endometrial stromal sarcoma?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.