Instructions:For each scenario described below, choose the single most appropriate tumour stage from the above list of options. Each option may be used once, more than once, or not at all.
Explanation
Question 6
A 65 year old woman presents to the gynaecology clinic with a 6 months history of a lump on her vulva. Biopsy confirms a squamous cell carcinoma and she undergoes radical vulvectomy + lymphadenectomy. Histology confirms a 1.5cm squamous cell carcinoma confined to the labia majora with 2mm stromal invasion. All lymph nodes are negative.
Question 7
A 70 year old woman presents with a 3 months history of a lump on her vulva. Biopsy confirms a squamous cell carcinoma and she undergoes radical vulvectomy + lymphadenectomy. Histology confirms a 3cm squamous cell carcinoma confined to the vulva with 2mm stromal invasion. All lymph nodes are negative.
why question 7 is stage 2?? if >2cm in size and >1mm invasion is 1b...stage 2 is when if thereis adjacent spread with negative nodes.
Thank you
Posted by Farrukh G.
No, your staging is incorrect.
Here are notes on staging according to FIGO 2009.
Staging of carcinoma of the vulva
Stage I
Tumour confined to the vulva
IA: Tumour ≤ 2cm in size, confined to the vulva or perineum with stromal invasion ≤ 1.0mm and no nodal metastases
IB: Tumour ≤ 2cm in size or with stromal invasion > 1.0mm, confined to the vulva or perineum with negative nodes
Stage II
Tumour of any size with extension to adjacent perineal structures (lower third of the vagina, lower third of the urethra or anus) with negative nodes
Stage III
Tumour of any size with or without extension to adjacent perineal structures (lower third of vagina, lower third of urethra or anus) with positive inguino-femoral nodes
IIIA: One lymph node metastasis ≥ 5mm or 1-2 lymph node metastases < 5mm
IIIB: Two or more lymph node metastases ≥ 5mm or 3 or more lymph node metastases < 5mm
IIIC: Positive nodes with extra-capsular spread
Stage IV
Tumour invades other regional structures (upper 2/3 of urethra, upper 2/3 of vagina) or distant structures
IVA: Tumour invades upper urethra and / or vaginal mucosa, bladder mucosa, rectal mucosa or fixed to pelvic bone or presence of fixed / ulcerated inguino-femoral nodes
IVB: Any distant metastases including pelvic nodes
Posted by dr sheela N.
IA Tumor confined to the vulva or perineum, ≤ 2cm in size with stromal invasion ≤ 1mm, negative nodes
IB Tumor confined to the vulva or perineum, > 2cm in size or with stromal invasion > 1mm, negative nodes
