Gynaecological oncology: uterine carcinosarcoma: 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: uterine carcinosarcoma

Sample item

A 70-year-old woman who had pelvic radiotherapy for rectal cancer years ago presents with postmenopausal bleeding and a polypoid uterine mass. Histology shows malignant epithelial and mesenchymal elements. How is this tumour regarded?

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

The answer and the reasoning

B. Carcinosarcoma, a high-grade metaplastic endometrial carcinoma treated with surgery and adjuvant platinum-based chemotherapy

Uterine carcinosarcoma (malignant mixed Mullerian tumour) contains both carcinomatous and sarcomatous elements and is considered a high-grade epithelial cancer undergoing metaplasia. Risk factors include previous pelvic radiotherapy, tamoxifen use and age. It is aggressive and is treated with staging surgery and chemotherapy such as carboplatin and paclitaxel.

Option by option

  • A. Low-grade endometrial stromal sarcoma

    Stromal sarcoma lacks a carcinomatous component.

  • B. Carcinosarcoma, a high-grade metaplastic endometrial carcinoma treated with surgery and adjuvant platinum-based chemotherapy (correct)

    Correct. Biphasic malignant histology is typical of carcinosarcoma.

  • C. Adenomyoma

    An adenomyoma is benign.

  • D. Benign mixed tumour

    It is a malignant, not benign, tumour.

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.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is B, Carcinosarcoma, a high-grade metaplastic endometrial carcinoma treated with surgery and adjuvant platinum-based chemotherapy. Uterine carcinosarcoma (malignant mixed Mullerian tumour) contains both carcinomatous and sarcomatous elements and is considered a high-grade epithelial cancer undergoing metaplasia.

Why is "Low-grade endometrial stromal sarcoma" not the answer?

Stromal sarcoma lacks a carcinomatous component.

Why is "Adenomyoma" not the answer?

An adenomyoma is benign.

Why is "Benign mixed tumour" not the answer?

It is a malignant, not benign, tumour.

What concept does this question test?

It tests Gynaecological oncology: uterine carcinosarcoma in OBG. Risk factors include previous pelvic radiotherapy, tamoxifen use and age. It is aggressive and is treated with staging surgery and chemotherapy such as carboplatin and paclitaxel.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: uterine carcinosarcoma?

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.