Gynaecological oncology: Lynch syndrome: 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: Lynch syndrome

Sample item

A woman with a family history of colorectal cancer develops endometrial carcinoma at 42 years. Which syndrome should be suspected?

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

The answer and the reasoning

C. Lynch syndrome (hereditary non-polyposis colorectal cancer)

Lynch syndrome results from mismatch repair gene mutations (MLH1, MSH2, MSH6, PMS2) and gives lifetime endometrial cancer risk of up to 40 to 60 per cent. Endometrial cancer may be the sentinel cancer. Risk-reducing hysterectomy with bilateral salpingo-oophorectomy is offered after childbearing.

Option by option

  • A. Peutz-Jeghers syndrome

    Peutz-Jeghers causes sex cord tumours with annular tubules.

  • B. Cowden syndrome

    Cowden syndrome is linked to breast and thyroid cancer, and also endometrial, but the colorectal pattern points to Lynch.

  • C. Lynch syndrome (hereditary non-polyposis colorectal cancer) (correct)

    Correct. Endometrial cancer with colorectal cancer history suggests Lynch syndrome.

  • D. Li-Fraumeni syndrome

    Li-Fraumeni is associated with sarcomas and breast 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.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Lynch syndrome (hereditary non-polyposis colorectal cancer). Lynch syndrome results from mismatch repair gene mutations (MLH1, MSH2, MSH6, PMS2) and gives lifetime endometrial cancer risk of up to 40 to 60 per cent.

Why is "Peutz-Jeghers syndrome" not the answer?

Peutz-Jeghers causes sex cord tumours with annular tubules.

Why is "Cowden syndrome" not the answer?

Cowden syndrome is linked to breast and thyroid cancer, and also endometrial, but the colorectal pattern points to Lynch.

Why is "Li-Fraumeni syndrome" not the answer?

Li-Fraumeni is associated with sarcomas and breast cancer.

What concept does this question test?

It tests Gynaecological oncology: Lynch syndrome in OBG. Endometrial cancer may be the sentinel cancer. Risk-reducing hysterectomy with bilateral salpingo-oophorectomy is offered after childbearing.

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: Lynch syndrome?

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.