Gynaecological oncology: serous endometrial carcinoma: 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: serous endometrial carcinoma

Sample item

A 72-year-old thin woman has postmenopausal bleeding, and biopsy shows high-grade serous endometrial carcinoma with strong p53 staining. Which statement describes this tumour compared with endometrioid carcinoma?

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

The answer and the reasoning

D. Not related to unopposed oestrogen, arises in atrophic endometrium and has a poor prognosis

Type II endometrial cancers, such as serous and clear cell carcinoma, arise in atrophic endometrium of older, non-obese women, are unrelated to oestrogen excess, and show TP53 mutations. They are aggressive with early spread, so surgical staging and adjuvant chemotherapy are used. Type I endometrioid tumours are oestrogen-related and have a better outlook.

Option by option

  • A. It is oestrogen dependent and has an excellent prognosis

    Oestrogen dependence and good prognosis describe type I tumours.

  • B. It responds well to progestin therapy

    Progestins are useful for well-differentiated type I tumours, not serous carcinoma.

  • C. It is associated with obesity and endometrial hyperplasia

    Obesity and hyperplasia are features of type I disease.

  • D. Not related to unopposed oestrogen, arises in atrophic endometrium and has a poor prognosis (correct)

    Correct. Serous carcinoma is oestrogen independent, p53 mutated and aggressive.

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.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is D, Not related to unopposed oestrogen, arises in atrophic endometrium and has a poor prognosis. Type II endometrial cancers, such as serous and clear cell carcinoma, arise in atrophic endometrium of older, non-obese women, are unrelated to oestrogen excess, and show TP53 mutations.

Why is "It is oestrogen dependent and has an excellent prognosis" not the answer?

Oestrogen dependence and good prognosis describe type I tumours.

Why is "It responds well to progestin therapy" not the answer?

Progestins are useful for well-differentiated type I tumours, not serous carcinoma.

Why is "It is associated with obesity and endometrial hyperplasia" not the answer?

Obesity and hyperplasia are features of type I disease.

What concept does this question test?

It tests Gynaecological oncology: serous endometrial carcinoma in OBG. They are aggressive with early spread, so surgical staging and adjuvant chemotherapy are used. Type I endometrioid tumours are oestrogen-related and have a better outlook.

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: serous endometrial carcinoma?

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.