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Unilateral ovarian tumor with ascites

Author: RxPG, Posted on Thursday, September 16 @ 00:00:00 IST by RxPG  

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Gynecology

Laporatomy performed in a case of ovarian tumor revealed unilateral ovarian tumor with ascities positive for malignatn cells and positive pelvic lymph nodes. All other structures were free of disease. what is stage of the disease:
1. Stage IIc.
2. Stage IIIa.
3. Stage IIIb.
4. Stage IIIc.


Answer
1. Stage IIc.
4. Stage IIIc.

Reference
Test book of Gynaecology 2nd Edition D.C.Dutta page 340
Shaw FIGO Staging

Quality
2 Spotters !!

Status
Repeat

QTDF
FIGO Staging is Given in all books

Discussion
Points given are
1. Ovarian Tumour
2. Unilateral
3. Ascites - Malignant Cells
4. Pelvic Nodes
Please refer to the FIGO Staging. It is Identical in Shaw and Durtta. The problem is with the interpretation. The constraints of space prevents me from putting this lengthly table here again. In short
Stage II is : Tumour involving one or both ovaries with pelvic extension
Stage III is : Tumour involving one or both ovaries with peritoneal implants outside the pelvis and/or positive retroperitoneal or inguinal nodes. Supf Liver Metastasis is State III
The classical description of Ascites containing Malignant cells fit in with the staging IIc. But
There is no mention of any lymph node in Stage IIc
When Retroperitoneal nodes are involved, it is Stage IIIc
The question says Pelvic node
Now if we consider
Pelvic node as a Pelvic Tissue, the
Answer will be IIc
Pelvic node as a Retroperitoneal Node, the
Answer will be IIIc

Explanation
1. The Tumour is Stage IIc if we consider Pelvic node as a Pelvic Tissue.
2. The Tumour cannot be Stage IIIa as in Stage IIIa Nodes are negative.
3. The Tumour cannot be Stage IIIb as in Stage IIIb Nodes are negative
4. The Tumour is Stage IIIc if we consider Pelvic node as a Retroperitoneal Node

Comments
You decide!!!

Tips
Most Question paper will have Questions from Staging and they will be 99 % Straightforward. This is a rare occasion where there is a controversy


 

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