Benign and malignant diseases of uterus and ovaries.
Obstetrics & Gynaecology · Topic 34
Source: NMC CBME Curriculum 2024 · Volume III · Obstetrics & Gynaecology · Topic 34 · combined PDF page 439
Practice questions
- A uterine smooth-muscle tumor is well circumscribed and shows infarct-type necrosis, mild focal atypia, and no coagulative tumor-cell necrosis. Which distinction is most directly supported by the reported case of a tumor later associated with ovarian lesions?
- A patient with a prior uterine leiomyoma is found to have a pulmonary smooth-muscle lesion that resembles the uterine tumor histologically. Which rare entity is described by this presentation?
- According to the supplied review, who first described benign metastasizing leiomyoma, and in what year?
- A woman develops bilateral ovarian smooth-muscle tumors 24 years after hysterectomy for a uterine smooth-muscle neoplasm. The ovarian lesions lack significant atypia and coagulative tumor-cell necrosis. Which interpretation best reflects the supplied case report?
- Which statement about the evidence for rare extrauterine behavior of leiomyoma is best supported by the supplied literature?
- In a premenopausal patient undergoing FDG PET, which additional clinical information is particularly important when interpreting uterine or ovarian uptake?
- A premenopausal patient has increased ovarian FDG uptake without a clearly established malignant diagnosis. Which conclusion is most appropriate?
- According to the supplied FDG PET review, increased uterine or ovarian uptake in a postmenopausal patient should be interpreted as indicating which broad category?
- What is the principal role of CT correlation when increased uterine or ovarian FDG uptake is seen?
- Which statement best captures the specificity of increased FDG uptake in a premenopausal ovary?
- A patient has increased endometrial FDG uptake, but the finding does not appear related to menstrual timing. Which statement is supported by the supplied review?
- Which histologic description is characteristic of uterine Müllerian adenosarcoma in the supplied series?
- Which microscopic stromal arrangement was described as characteristic of uterine Müllerian adenosarcoma?
- In the supplied uterine adenosarcoma series, which pathologic feature was associated with an especially poor outcome?
- A patient presents with abnormal uterine bleeding and a polypoid uterine lesion. Which statement about diagnosing Müllerian adenosarcoma is most appropriate based on the supplied evidence?
- What management principle is supported by the supplied retrospective adenosarcoma series?
- In the supplied nine-case adenosarcoma series, how many tumors were reported as clinical stage I?
- A 57-year-old postmenopausal woman has irregular bleeding and solid-cystic uterine and ovarian masses. Histology shows well-differentiated squamous carcinoma contiguous with squamous metaplasia in ectopic endometrial glands. Which interpretation matches the supplied case report?
- In the supplied endometriosis-associated squamous carcinoma case, what morphologic finding supported the proposed origin of carcinoma from ectopic endometrial tissue?
- What is the best evidence-based inference from the supplied report of carcinoma associated with endometriosis?
- A mass is found in the broad ligament, separate from the uterus and ovaries at surgery. It has a thick wall resembling myometrium and a cystic center lined by endometrial-type tissue. What diagnosis was described in the supplied report?
- In the reported broad-ligament uterus-like mass, which immunohistochemical profile was described for the cyst lining and stromal cells?
- A large solid pelvic mass has histology showing densely cellular fibroblastic spindle cells and mild nuclear atypia. Which term best matches the supplied ovarian fibroma report?
- Which findings were emphasized as important in distinguishing cellular fibroma or mitotically active cellular fibroma from fibrosarcoma?
- A very large cellular pelvic fibroma is being evaluated for possible malignancy. Which pathology approach is specifically supported by the supplied report?
- A 62-year-old woman has ascites, CA-125 of 1291 U/mL, and imaging suggestive of metastatic ovarian cancer. At surgery, the ovaries and peritoneum appear normal and a retroperitoneal mass is found; histology shows fibrothecoma. Which conclusion best fits the supplied report?
- Before initiating neoadjuvant chemotherapy for a presumed epithelial ovarian cancer, what lesson is emphasized by the supplied extraovarian fibrothecoma case report?
- Which description best defines ovarian fibroma in the supplied pathology report?