Gynaecological Oncology · NEET PG Preparation Obstetrics & Gynaecology
A 45-year-old nulliparous woman presents with abnormal uterine bleeding. Transvaginal ultrasonography reveals an endometrial thickness of 14 mm. Endo…
Practice question from Gynaecological Oncology (NEET PG Preparation Obstetrics & Gynaecology), with the correct answer and a step-by-step solution.
medium · MCQ · Q-F34F18
A 45-year-old nulliparous woman presents with abnormal uterine bleeding. Transvaginal ultrasonography reveals an endometrial thickness of 14 mm. Endometrial biopsy shows complex atypical hyperplasia. Which of the following is the most appropriate initial management for this patient, assuming she has completed childbearing?
- A.Total hysterectomy with bilateral salpingo-oophorectomyCorrect answer
- B.High-dose oral progestins (Megestrol acetate)
- C.Levonorgestrel-releasing intrauterine system (LNG-IUS)
- D.Serial endometrial biopsies every 3 months
Solution
In women with complex atypical endometrial hyperplasia who have completed childbearing, the standard and definitive treatment is a total hysterectomy due to a 30-40% risk of concurrent invasive endometrial carcinoma. Conservative management with progestins or LNG-IUS is reserved only for patients desiring future fertility.
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