In a case of carcinoma cervix, hydronephrosis or renal involvement is seen in:
Ans: B (Stage 3b) Ref: Slum 's Textbook of Gynecolgy pg 4T2Explanation:CARCINOMA CERVIX STAGINGStage IStage I is carcinoma strictly confined to the cervix.The diagnosis of both Stages 1A1 and IA2 should be based on microscopic examination of removed tissue, preferably a cone, which must include the entire lesion.Stage IA: Invasive cancer identified only microscopically. Invasion is limited to measured stromal invasion with a maximum depth of 5 mm and no wider than 7 mm.Stage IA1: Stage IA1: Measured invasion of the stroma no greater than 3 mm in depth and no wider than 7 mm diameter.Stage IA2: Stage IA2: Measured invasion of stroma greater than 3 mm but no greater than 5 mm in depth and no wider than 7 mm in diameter.Stage IB: Stage IB: Clinical lesions confined to the cervix or precltnical lesions greater than Stage IA. All gross lesions even with superficial invasion are Stage IB cancers.Stage Hit: Stage IB 1: Clinical lesions no greater than 4 cm in size.Stage IB2: Stage IB2: Clinical lesions greater than 4 cm in size.Stage IIStage II is carcinoma that extends beyond the cervix, but does not extend into the pelvic wall.The carcinoma involves the vagina, but not as far as the lower third.Stage IIA: No obvious parametrial involvement. Involvement of up to the upper two- thirds of the vagina. Gynecoid(50% of Women )Android1.23% of Women)Anthropoid(24 % of Women)Platyelloid(3% of Women)BrimSightly ovoid or transversely roundedHeart-shaped,angulatedOval, wideranteroposteriorlyFlattened anteroposteriorly,wide transverselyDepthSidwallsIschial spinesSacrumRound OModerateStraightBlum, some-whatwidely separatedDeep, curvedHeartDeepConvergentProminent, narrow interspinous diameterSlightly curved, terminal portion often beakedOval DeepStraightProminent, often with narrow interspinous diameterSlightly curvedFlatShallowStraightBlunted, widely separatedSlightly curvedSubpubic arch Usual mode of birthWideVagina]SpontaneousOccipitoanteriorpositionNarrowCesareanVaginalDifficult with forcepsNarrow-VaginalForceps, Spontaneous Occipitoposterior or occipitoanterior positionWideVaginalSpontaneousStage IAB: Obvious parametrial involvement, but not into the pelvic sidewall.Stage IIIStage III is carcinoma that has extended into the pelvic sidewall.On rectal examination, there is no cancer-free space between the tumour and the pelvic sidewall.The tumour involves the lower third of the vagina,All cases with hydronephrosis or a nonfunctioning kidney are Stage III cancers.Stage III A: No extension into the pelvic sidewall but involvement of the lower third of the vagina.Stage 1IIB: Extension into the pelvic side- wall or hydronephrosis or non-functioning kidney.Stage IVStage IV is carcinoma that has extended beyond the true pelvis or has clinically involved the mucosa of the bladder and/or rectum.Stage IVA: Spread of the tumour into adjacent pelvic organs.Stage IVB: Spread to distant organs.
Stage 3a
Stage 3b
Stage 2
Stage 4
Miscellaneous (Obs)