Question

What is the stage of an ovarian cancer with bilateral involvement, capsular rupture, and positive ascitic fluid for malignant cells?

• A. I
• B. II
• C. III
• D. IV

Hint:

Capsule rupture plus positive ascitic cytology in a tumor confined to the ovaries defines FIGO stage IC, a substage of stage I.

Answer 1

The Correct Option is A

Step 1: Understanding the Question.
The case describes an ovarian cancer that involves both ovaries, has a ruptured capsule, and shows malignant cells in the ascitic fluid. We need to place this picture into the correct FIGO stage.

Step 2: Key Concept or Approach.
FIGO staging for ovarian cancer first asks whether the growth stays inside the ovaries or spreads out.
Stage I means the growth is limited to one or both ovaries. Within stage I:
Stage IA is one ovary, capsule intact, no tumor on the surface, no malignant cells in fluid.
Stage IB is both ovaries, capsule intact, no surface tumor, no malignant cells in fluid.
Stage IC is one or both ovaries with capsule rupture, tumor on the ovarian surface, or malignant cells found in the ascites or peritoneal washings.
Stage II adds spread within the pelvis, stage III adds spread beyond the pelvis or to lymph nodes, and stage IV means the cancer has reached distant organs.

Step 3: Detailed Explanation.
Here, both ovaries are involved but there is no mention of spread to the uterus, tubes, pelvic peritoneum, lymph nodes, or distant organs, so stages II, III, and IV do not fit this case.
The capsule rupture and the positive ascitic cytology are the two features that define stage IC, one of the three substages of stage I.
Bilateral disease alone does not push the stage higher, since the staging rests on where the tumor cells are found, not on how many ovaries carry the growth.
So this case sits inside stage I, specifically substage IC.

Step 4: Final Answer.
The disease is confined to the ovaries, with capsule rupture and positive ascitic cytology, which is FIGO stage I (substage IC).
\[ \boxed{\text{Stage I}} \]