This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Carcinoma Endometrium, Subject name: Gynaecology & Obstetrics
Endometrial Ca with poor prognosis: 
Select and explain. 
A. Adeno grade 2, B. Adenosquamous, C. Adenoacanthoma, D. Clear cell
D: Clear cell
Answer: D: Clear cell 
Explanation: Ref: Novak's Gynecology. 14'h ed. Pg 1359. Explanation:The following cases have poor prognosis in endometrial cancer and require pelvic and paraaortic lymph node dissection during surgery.Tumor histology clear cell, serous, squamous, or grade 2-3 endometrioidMyometrial invasion >ViIsthmus-cervix extensionTumor size >2 cmExtrauterine disease