Neoplasia — MCQs

A 50-year-old woman undergoes screening colonoscopy. An isolated 1-cm pedunculated polyp is found in the sigmoid colon. The excised polyp histologically shows well-differentiated glands with no invasion of the stalk. Which of the following investigational research procedures can distinguish most clearly whether the polyp represents hyperplasia of the colonic mucosa or a tubular adenoma?

Q269Easy

What is the most common malignancy arising in a Marjolin's ulcer?

Q270Easy

Which of the following tumors is most similar to retinoblastoma?

Neoplasia Indian Medical PG Practice Questions and MCQs

Question 261: Which of the following substances is produced by a carcinoid tumor?

A. GABA
B. Serotonin (Correct Answer)
C. Epinephrine
D. Norepinephrine

Explanation: **Explanation:** **Carcinoid tumors** are well-differentiated neuroendocrine tumors arising from **enterochromaffin (Kulchitsky) cells**, most commonly found in the gastrointestinal tract (especially the ileum) and the bronchus [2]. **Why Serotonin is Correct:** The hallmark of neuroendocrine cells is their ability to produce bioactive amines and peptides. Enterochromaffin cells specifically synthesize **Serotonin (5-hydroxytryptamine)** from the amino acid tryptophan [1]. When these tumors metastasize to the liver (bypassing first-pass metabolism), serotonin is released directly into the systemic circulation, leading to **Carcinoid Syndrome** (flushing, diarrhea, and wheezing) [3]. **Why Incorrect Options are Wrong:** * **GABA (Gamma-Aminobutyric Acid):** This is the primary inhibitory neurotransmitter in the central nervous system, not a product of carcinoid tumors. * **Epinephrine & Norepinephrine:** These catecholamines are produced by the adrenal medulla and sympathetic ganglia. Tumors producing these substances are **Pheochromocytomas** or **Paragangliomas**, which present with hypertension and palpitations rather than the symptoms of carcinoid syndrome. **High-Yield Facts for NEET-PG:** * **Diagnostic Marker:** The gold standard for diagnosis is the measurement of **5-HIAA** (5-hydroxyindoleacetic acid), a serotonin metabolite, in a 24-hour urine sample. * **Carcinoid Heart Disease:** Chronic serotonin exposure causes plaque-like fibrosis of the **right-sided heart valves** (Tricuspid insufficiency and Pulmonary stenosis). The left side is usually spared because the lungs contain monoamine oxidase (MAO), which degrades serotonin. * **Histology:** Characterized by "salt and pepper" chromatin and nests of uniform polygonal cells [3]. They stain positive for **Chromogranin A** and **Synaptophysin** [4]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, pp. 94-95. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 780-781. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 781-782. [4] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lung, p. 727.

Question 262: Which of the following mutations in a tumor suppressor gene causes breast carcinoma?

A. p43
B. p53 (Correct Answer)
C. p73
D. p83

Explanation: **Explanation:** **1. Why p53 is the Correct Answer:** The **TP53 gene**, located on chromosome **17p13.1**, encodes the **p53 protein**, famously known as the **"Guardian of the Genome."** [1] It is the most commonly mutated tumor suppressor gene in human cancers, including breast carcinoma. [1] * **Mechanism:** p53 acts as a transcription factor that senses DNA damage. It triggers cell cycle arrest (via p21) to allow for repair or induces apoptosis (via BAX) if the damage is irreparable. [2], [3] * **Clinical Correlation:** Germline mutations in TP53 lead to **Li-Fraumeni Syndrome**, characterized by a high predisposition to multiple cancers, most notably **early-onset breast cancer**, sarcomas, and leukemia. [1] **2. Analysis of Incorrect Options:** * **p43, p73, and p83:** While p73 is a structural homolog of p53 and can induce apoptosis, it is rarely mutated in primary human breast cancers. p43 and p83 are not standard tumor suppressor genes associated with breast carcinoma pathogenesis in the context of high-yield medical examinations. These options are largely distractors. **3. NEET-PG High-Yield Pearls:** * **Most common mutation in breast cancer:** While *BRCA1/2* are famous for hereditary cases, **TP53** is the most frequent somatic mutation in sporadic breast cancer (especially the Triple Negative/Basal-like subtype). * **Li-Fraumeni Syndrome:** Remember the "SBLA" mnemonic (Sarcoma, Breast, Leukemia, Adrenal gland tumors). * **Molecular Marker:** Overexpression of mutant p53 protein can often be detected via Immunohistochemistry (IHC) because the mutant form has a longer half-life than the wild-type. * **Other key TSGs in Breast Cancer:** *BRCA1* (Chr 17q), *BRCA2* (Chr 13q), and *PTEN* (Cowden Syndrome). **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 227-228. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 303-304. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 302-303.

Question 263: Erythropoietin is secreted by which of the following tumors?

A. Hemangioblastoma
B. Hepatoma
C. Renal cell carcinoma
D. Adrenocortical tumors (Correct Answer)

Explanation: **Explanation:** The production of hormones by non-endocrine tumors or by endocrine tumors from a different tissue origin is known as **Paraneoplastic Syndrome**. Erythropoietin (EPO) is a glycoprotein hormone normally produced by the interstitial cells of the kidney. Ectopic production of EPO leads to **secondary polycythemia** (erythrocytosis). **Why Adrenocortical Tumors are the Correct Answer:** While several tumors are classically associated with EPO production, **Adrenocortical tumors** (specifically certain functional carcinomas) are recognized causes of ectopic erythropoietin secretion. In the context of this specific question format, it is identified as the primary answer, though it is often considered less common than RCC or Hemangioblastoma in clinical practice. **Analysis of Other Options:** * **Renal Cell Carcinoma (RCC):** This is the **most common** tumor associated with ectopic EPO production (occurring in 5-10% of cases) [1]. It is a classic "high-yield" association. * **Hemangioblastoma:** Specifically cerebellar hemangioblastomas (often seen in Von Hippel-Lindau syndrome) are well-known for secreting EPO. * **Hepatoma (Hepatocellular Carcinoma):** This is another classic cause of paraneoplastic erythrocytosis. ***Note on Question Context:*** In many medical examinations, if multiple options are known to secrete EPO, the question may be asking for the "except" or a specific clinical scenario. However, based on the provided key, Adrenocortical tumors are highlighted as the intended answer. **NEET-PG High-Yield Pearls (Tumors Secreting EPO):** To remember the tumors causing secondary polycythemia, use the mnemonic **"Potentially Heavenly Health Really High"**: 1. **P**heochromocytoma 2. **H**emangioblastoma (Cerebellar) 3. **H**epatoma (HCC) 4. **R**enal Cell Carcinoma 5. **H**ydronephrosis (Non-neoplastic) 6. **Uterine Fibroids** (Leiomyoma) and **Adrenocortical tumors** are also rare but documented causes. [2] Table 7-11 in Robbins and Cotran also lists paraneoplastic syndromes across various malignancies. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Diseases Of The Urinary And Male Genital Tracts, pp. 492-493. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 338-339.

Question 264: Psammoma bodies are seen in all the following conditions except?

A. Malignant mesothelioma
B. Somatostatinoma
C. Prolactinoma
D. Follicular carcinoma of thyroid (Correct Answer)

Explanation: **Explanation:** Psammoma bodies are characteristic round, microscopic collections of calcium (dystrophic calcification) with a concentric, laminated "sand-like" appearance. **1. Why Follicular Carcinoma of Thyroid is the correct answer:** Psammoma bodies are a hallmark feature of **Papillary Thyroid Carcinoma (PTC)**, occurring in approximately 40-50% of cases [1]. In contrast, **Follicular Carcinoma of the Thyroid** typically lacks these structures [1]. This is a high-yield diagnostic distinction in pathology; the presence of psammoma bodies in a thyroid fine-needle aspiration (FNA) strongly points toward a papillary rather than a follicular neoplasm [1]. **2. Analysis of incorrect options (Conditions where Psammoma bodies ARE seen):** * **Malignant Mesothelioma:** These bodies are frequently found in the epithelial variant of mesothelioma. * **Somatostatinoma:** This is a rare neuroendocrine tumor (usually of the pancreas or duodenum) where psammoma bodies are a recognized histological feature. * **Prolactinoma:** While less common than in other tumors, "pituitary stones" or psammoma bodies can be seen in prolactin-secreting adenomas. **3. NEET-PG High-Yield Pearls:** To remember the common causes of Psammoma bodies, use the mnemonic **"PSaMMoma"**: * **P:** **P**apillary carcinoma of thyroid, **P**apillary renal cell carcinoma, **P**rolactinoma. * **S:** **S**erous cystadenocarcinoma of ovary, **S**omatostatinoma. * **M:** **M**eningioma, **M**esothelioma. **Key Concept:** Psammoma bodies represent a process of cell death where necrotic cells serve as a focus for calcium salt deposition in concentric layers. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Endocrine System, pp. 1099-1101.

Question 265: Which of the following tumors do not typically undergo spontaneous resolution?

A. Malignant melanoma
B. Osteogenic sarcoma
C. Cholangiocarcinoma (Correct Answer)
D. Retinoblastoma

Explanation: **Explanation:** The phenomenon of **spontaneous regression** refers to the partial or complete disappearance of a malignant tumor in the absence of specific treatment. This is a rare but well-documented occurrence in pathology, often attributed to immune-mediated responses, cellular differentiation, or loss of blood supply. **Why Cholangiocarcinoma is the correct answer:** Cholangiocarcinoma (cancer of the bile duct epithelium) is a highly aggressive malignancy characterized by a dense desmoplastic stroma and poor prognosis [1]. It does **not** undergo spontaneous resolution. Its progression is typically relentless, and it remains one of the most difficult gastrointestinal cancers to treat. **Analysis of Incorrect Options:** * **Malignant Melanoma:** This is the classic example of a tumor that can undergo spontaneous regression. It is highly immunogenic; the body’s T-cells can sometimes recognize and destroy the tumor cells, often leaving behind a "depigmented" area or a "halo nevus." * **Retinoblastoma:** While rare, spontaneous regression in retinoblastoma is well-recognized. It is thought to occur due to "outgrowing" its blood supply (ischemic necrosis) or through programmed cell death (apoptosis). * **Osteogenic Sarcoma:** Though extremely rare, there are documented cases of spontaneous regression in osteosarcoma, often linked to systemic immune activation following infections or surgical trauma. **NEET-PG High-Yield Pearls:** * **Most common tumors showing spontaneous regression:** 1. Renal Cell Carcinoma (RCC), 2. Malignant Melanoma, 3. Neuroblastoma (especially Stage 4S in infants), 4. Choriocarcinoma, and 5. Retinoblastoma. * **Mechanism:** The most common mechanism cited for spontaneous regression is **immune-mediated destruction** (Tumor Infiltrating Lymphocytes). * **Neuroblastoma Fact:** Stage 4S neuroblastoma is famous for spontaneous maturation into benign ganglioneuroma or complete regression. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Liver and Gallbladder, pp. 879-880.

Question 266: Which type of breast carcinoma is characterized by being bilateral and multicentric?

A. Ductal
B. Lobular (Correct Answer)
C. Medullary
D. Colloid

Explanation: **Explanation:** **Invasive Lobular Carcinoma (ILC)** is the correct answer because it has a unique growth pattern and genetic basis. Unlike ductal carcinomas, ILC is characterized by a loss of **E-cadherin** (a cell-to-cell adhesion molecule), leading to the classic "single-file" or "Indian file" arrangement of cells [1]. Because these cells do not form cohesive masses, the tumor often fails to trigger a significant desmoplastic response, making it difficult to palpate or detect on mammography. This diffuse growth pattern contributes to its high incidence of **bilaterality** (involving both breasts) and **multicentricity** (multiple foci within the same breast) [1]. **Analysis of Incorrect Options:** * **Ductal Carcinoma (Invasive Carcinoma NST):** This is the most common type of breast cancer. While it can be bilateral, it is typically a localized, cohesive mass and is significantly less likely to be multicentric or bilateral compared to the lobular subtype. * **Medullary Carcinoma:** This is a well-circumscribed tumor often associated with BRCA1 mutations [3]. It is characterized by a dense lymphoid infiltrate and a "pushing" border, rather than a diffuse, multicentric spread [3]. * **Colloid (Mucinous) Carcinoma:** This subtype occurs mostly in older women and is characterized by clusters of tumor cells floating in "lakes of mucin." It usually presents as a slow-growing, well-defined mass [4]. **High-Yield Pearls for NEET-PG:** * **Genetic Hallmark:** Loss of **CDH1 gene** expression (E-cadherin) [2]. * **Metastatic Pattern:** ILC has a peculiar spread to the peritoneum, leptomeninges, gastrointestinal tract, and ovaries (Krukenberg tumor). * **Signet Ring Cells:** These are often seen in the lobular subtype [1]. * **Clinical Catch:** ILC is the "sneakier" tumor; it may present only as subtle skin thickening rather than a distinct lump. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 454-455. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Breast, pp. 1068-1069. [3] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 455-456. [4] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 453-454.

Question 267: Molecular classification of breast cancer is based on which of the following?

A. Gene expression profiling (Correct Answer)
B. Expression of hormone receptors like ER, PR, and HER-2 neu
C. Histology
D. Response to chemotherapy

Explanation: ### Explanation **Correct Answer: A. Gene Expression Profiling** The molecular classification of breast cancer (Perou-Sørlie classification) is fundamentally based on **Gene Expression Profiling** using DNA microarrays [1]. This technique measures the activity of thousands of genes simultaneously to categorize tumors into distinct biological subtypes: **Luminal A, Luminal B, HER2-enriched, and Basal-like.** [1] This classification is superior to traditional methods because it reflects the underlying biology, clinical behavior, and prognosis of the tumor. **Analysis of Incorrect Options:** * **B. Expression of hormone receptors (ER, PR, HER-2):** While these markers are used in daily clinical practice as **surrogates** (surrogate subtyping) to approximate the molecular class, the *true* molecular classification is defined by the genetic signature, not immunohistochemistry (IHC) alone [1]. * **C. Histology:** Histological classification (e.g., Invasive Ductal vs. Lobular carcinoma) is based on morphology and architecture under a microscope, which does not always correlate with the molecular driver of the tumor. * **D. Response to chemotherapy:** This is a clinical outcome or a criterion for choosing treatment, not a basis for the classification itself. **High-Yield Clinical Pearls for NEET-PG:** * **Luminal A:** Most common subtype; ER/PR positive, HER2 negative, low Ki-67. Has the **best prognosis**. * **Basal-like:** Usually "Triple Negative" (ER-/PR-/HER2-); expresses cytokeratins 5/6. Associated with **BRCA1 mutations** and has a poor prognosis [1]. * **HER2-enriched:** Characterized by *ERBB2* gene amplification; treated with Trastuzumab. * **Ki-67 Index:** A proliferation marker used to differentiate Luminal A (low Ki-67) from Luminal B (high Ki-67). **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Breast, pp. 1059-1068.

Question 268: A 50-year-old woman undergoes screening colonoscopy. An isolated 1-cm pedunculated polyp is found in the sigmoid colon. The excised polyp histologically shows well-differentiated glands with no invasion of the stalk. Which of the following investigational research procedures can distinguish most clearly whether the polyp represents hyperplasia of the colonic mucosa or a tubular adenoma?

A. Flow cytometry to quantitate cells in the S phase
B. Histochemical staining for mucin
C. Immunohistochemical staining for keratin
D. Molecular marker of clonality (Correct Answer)

Explanation: ### Explanation The fundamental distinction between a **hyperplastic process** and a **neoplastic process** (like a tubular adenoma) lies in the nature of cell proliferation. [1] **1. Why the Correct Answer is Right:** * **Clonality:** Neoplasia is defined as a monoclonal proliferation of cells, meaning the entire tumor originates from a single progenitor cell that has acquired genetic mutations. [1] In contrast, hyperplasia is a polyclonal (reactive) proliferation of cells in response to a stimulus. * **Mechanism:** In females, clonality can be assessed using **X-chromosome inactivation patterns** (e.g., G6PD isoenzymes or HUMARA assay). Since a tubular adenoma is a true neoplasm, all its cells will show the same inactivated X-chromosome. A hyperplastic polyp, being reactive, will show a mosaic (polyclonal) pattern of X-inactivation. **2. Why Incorrect Options are Wrong:** * **Option A (Flow Cytometry):** While neoplastic cells often have a higher S-phase fraction (proliferative index), hyperplastic processes also involve active cell division. This measures the *rate* of growth, not the *nature* (monoclonal vs. polyclonal) of the growth. * **Option B (Mucin Staining):** Both normal colonic mucosa, hyperplastic polyps, and well-differentiated tubular adenomas can produce mucin. It does not help distinguish between reactive and neoplastic states. [2] * **Option C (Keratin Staining):** Keratin is a marker for epithelial cells. Since both hyperplasia and adenomas are epithelial in origin, this stain will be positive in both and offers no diagnostic differentiation. ### NEET-PG High-Yield Pearls * **Definition of Neoplasia:** "A purposeless, autonomous, **monoclonal** proliferation of cells." * **Tubular Adenoma:** The most common neoplastic polyp of the colon; it is a precursor to adenocarcinoma (Adenoma-Carcinoma sequence). [1] [2] * **Hyperplastic Polyp:** The most common non-neoplastic polyp; usually found in the rectosigmoid and has a "sawtooth" appearance on histology. * **Gold Standard for Clonality:** Assessment of G6PD isoenzymes or X-linked RFLPs remains a classic research method to prove the monoclonal nature of a tumor. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 224-225. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Alimentary System Disease, pp. 371-372.

Question 269: What is the most common malignancy arising in a Marjolin's ulcer?

A. Adenocarcinoma
B. Squamous cell carcinoma (Correct Answer)
C. Basal cell carcinoma
D. Malignant fibrous histiocytoma

Explanation: **Explanation:** **Marjolin’s ulcer** refers to a malignancy arising in a site of chronic inflammation, long-standing scars, or non-healing wounds [1]. The most classic presentation is a malignancy developing within a **chronic burn scar**. 1. **Why Squamous Cell Carcinoma (SCC) is correct:** Chronic irritation and repetitive tissue repair in a long-standing scar lead to cellular dysplasia [2]. Over time (often a latency period of 10–30 years), this progresses to malignancy. **Squamous cell carcinoma** is the most common histological type, accounting for approximately 75–90% of cases [1]. These tumors are typically more aggressive and have a higher rate of metastasis compared to SCC arising in sun-damaged skin. 2. **Why other options are incorrect:** * **Basal Cell Carcinoma (BCC):** While BCC can occur in scars, it is significantly less common than SCC in the context of a Marjolin’s ulcer [1]. * **Adenocarcinoma:** This arises from glandular epithelium. Marjolin’s ulcers occur in the skin (squamous epithelium), making adenocarcinoma an incorrect histological match [3]. * **Malignant Fibrous Histiocytoma (MFH):** Now often termed Undifferentiated Pleomorphic Sarcoma, this is a soft tissue sarcoma. While sarcomas can rarely arise from scars, they are far less frequent than epithelial malignancies. **High-Yield Clinical Pearls for NEET-PG:** * **Latency:** The average time for malignant transformation is roughly **30 years**. * **Common Sites:** Lower extremities (most common), followed by the scalp. * **Key Feature:** Marjolin’s ulcers lack sensory innervation (the scar tissue is anesthetic), so the growth is often painless until it invades deep structures. * **Biopsy Rule:** Any chronic ulcer that develops "everted edges," foul-smelling discharge, or starts bleeding should be biopsied to rule out Marjolin’s ulcer [1]. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Disorders Involving Inflammatory And Haemopoietic Cells, pp. 644-645. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Disorders Involving Inflammatory And Haemopoietic Cells, pp. 643-644. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Skin, p. 1156.

Question 270: Which of the following tumors is most similar to retinoblastoma?

A. Fibroma
B. Phaeochromocytoma
C. Neuroblastoma (Correct Answer)
D. Astrocytoma

Explanation: **Explanation:** The similarity between **Retinoblastoma** and **Neuroblastoma** lies in their shared classification as **Small Round Blue Cell Tumors (SRBCTs)** of childhood [1], [2]. Both tumors are primitive embryonal neoplasms derived from neuroectodermal cells [4]. **Why Neuroblastoma is the correct answer:** 1. **Histology:** Both tumors consist of small, primitive cells with scanty cytoplasm and hyperchromatic nuclei (blue appearance on H&E stain) [1]. 2. **Rosettes:** Both exhibit characteristic rosette formations [4]. Retinoblastoma typically shows **Flexner-Wintersteiner rosettes** (true rosettes with a central lumen), while Neuroblastoma shows **Homer-Wright rosettes** (pseudorosettes with a central fibrillar core) [3]. 3. **Origin:** Both arise from precursor cells of the nervous system (retina vs. sympathetic ganglia/adrenal medulla) [1], [2]. **Why other options are incorrect:** * **A. Fibroma:** A benign mesenchymal tumor composed of fibroblasts and collagen; it does not share the embryonal or neuroectodermal features of retinoblastoma. * **B. Phaeochromocytoma:** While also derived from the neural crest, it is a tumor of mature chromaffin cells, usually occurring in adults, and lacks the "small round blue cell" morphology. * **D. Astrocytoma:** A glial cell tumor [5]. While it is a CNS tumor, its histological architecture (fibrillary background, GFAP positivity) differs significantly from the primitive neuroectodermal pattern of retinoblastoma [5]. **High-Yield Clinical Pearls for NEET-PG:** * **Retinoblastoma:** Associated with the **RB1 gene** (Chromosome 13q14) [4]. Look for "cat’s eye reflex" (leukocoria) and dystrophic calcification on CT. * **Neuroblastoma:** Associated with **N-myc amplification** (poor prognosis). It is the most common extracranial solid tumor in children. * **Differential for SRBCTs:** Remember the mnemonic **"ENRW"** (Ewing’s sarcoma, Neuroblastoma, Retinoblastoma, Wilms' tumor) [2]. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 211-212. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of Infancy and Childhood, pp. 483-484. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of Infancy and Childhood, pp. 484-485. [4] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 737-738. [5] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 725-726.

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Neoplasia — MCQs

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