OSCE — Endometrial Cancer

Brief (to candidate)

You will assess a patient with a presentation consistent with Endometrial Cancer.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.

Clinical context

Endometrial cancer is the most common gynaecological malignancy in developed countries and the sixth most common cancer in women. Around 90 per cent present with postmenopausal bleeding, which is cancer until proven otherwise. Two pathogenetic types exist: Type I (endometrioid, 80 per cent) is oestrogen-driven, arising through unopposed oestrogen stimulation, endometrial hyperplasia with atypia and well-differentiated carcinoma, with PTEN, PIK3CA, KRAS and ARID1A mutations and a favourable prognosis; Type II (serous, clear cell, carcinosarcoma, 20 per cent) is not oestrogen-driven, arises in atrophic endometrium, carries TP53 mutations, and is aggressive. Diagnosis is by transvaginal ultraso

Candidate tasks

1. Clarify onset, severity, associated features, and red-flag symptoms.
2. State focused examination priorities.
3. List first-line investigations and any named score/criteria.
4. Give immediate resuscitation steps.
5. Outline definitive management with doses/routes where standard.
6. Name complications and disposition (ward / HDU / theatre / discharge safety-net).
7. Mention one special-population modifier (pregnancy, child, elderly, CKD).

Examiner checklist

Model outline

Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.