internal medicine
38-year-old man with a history of alcohol abuse presents to you with symptoms of sinusitis
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A 58-year-old woman presents to you with a 4-month history of postcoital spotting. She has not seen a physician in 5 years, and she has not had a Pap smear since the birth of her last child 25 years ago. She is monogamous and has been for 30 years. She denies any other episodes of bleeding, denies a history of sexually transmitted infections, denies foul-smelling vaginal discharge, and denies dyspareunia. She admits to smoking a half-pack per day of a tobacco product and has smoked since she was 16 years of age.
On physical examination, her cervix is easily visualized and significant for a fungating exophytic mass at the cervical os approximately 1 cm in width. The mass does appear to be confined to the cervix, and no obvious vaginal involvement is present.
On rectovaginal examination, no obvious parametrial involvement is present to palpation. Findings on complete blood count and basic metabolic profile are normal. Chest x-ray from an emergency department visit 1 week ago was negative. You decide to order biopsy and computed tomography (CT).
Biopsy of the mass reveals squamous cell carcinoma. The CT results from her abdomen/pelvis are not yet available.
Which of the following best describes the International Federation of Gynecology and Obstetrics (FIGO) staging of this patient’s cancer?
- Stage Ib1
- Stage IIa
- Stage IIb
- Stage IIIa
- Stage Ib2
This question appears in Med-Challenger OBGYN Exam Review with CME
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