Neoplasia Practice Questions

Q: All of the following are examples of tumor markers, except?

Alpha-HCG (a-HCG). ### Explanation **1. Why Alpha-HCG (a-HCG) is the correct answer:** Human Chorionic Gonadotropin (HCG) is a glycoprotein hormone consisting of two subunits: **alpha (α)** and **beta (β)**. The α-subunit is identical to those found in LH, FSH, and TSH. Because it lacks specificity, α-HCG is **not** used as a tumor marker. In clinical practice and oncology, the **Beta-subunit (β-HCG)** is the specific tumor marker used to monitor conditions like Gestational Trophoblastic Disease (Hydatidiform mole/Choriocarcinoma) and Germ Cell Tumors (Seminoma/Non-seminomatous tumors) [1]. **2. Analysis of Incorrect Options:** * **Alpha-Fetoprotein (AFP):** A high-yield marker produced by the fetal yolk sac and liver. It is a classic marker for **Hepatocellular Carcinoma (HCC)** and **Non-seminomatous germ cell tumors** (specifically Yolk Sac Tumors) [2]. * **Thyroglobulin:** Produced by follicular cells of the thyroid. It is used as a highly specific marker to detect recurrence or metastasis in **Papillary and Follicular Thyroid Carcinomas** after total thyroidectomy. * **β2-microglobulin:** A component of MHC Class I molecules. It serves as a prognostic marker for hematological malignancies, most notably **Multiple Myeloma** and certain Lymphomas. **3. NEET-PG High-Yield Pearls:** * **Most specific marker for Pancreatic Cancer:** CA 19-9. * **Marker for Medullary Carcinoma of Thyroid:** Calcitonin. * **Marker for Ovarian Cancer:** CA-125 (Surface epithelial tumors). * **Prostate Cancer:** PSA (Prostate Specific Antigen) is organ-specific but not cancer-specific (can rise in BPH/Prostatitis) [2]. * **Oncofetal Antigens:** Include AFP and CEA (Carcinoembryonic Antigen) [2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Female Genital Tract, pp. 1035-1036. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, p. 346.

Q: Which of the following lesions is described as destructively invasive and locally malignant with rare metastasis?

Ameloblastoma. **Explanation:** The question describes a classic pathological behavior known as **"locally malignant"** or **"borderline"** neoplasia. **Why Ameloblastoma is correct:** Ameloblastoma is a primary odontogenic tumor, most commonly occurring in the mandible [2]. It is characterized by a "locally aggressive" nature. While it is histologically benign in most cases, it is **destructively invasive**, often causing significant bone resorption and expansion. Despite its ability to infiltrate surrounding tissues extensively, it has a **very low potential for metastasis** (rarely spreading to the lungs). This combination of local destruction without systemic spread defines its classification as a locally malignant tumor. **Why other options are incorrect:** * **A. Fibroma:** This is a purely **benign** mesenchymal tumor. It is encapsulated, slow-growing, and does not invade surrounding tissues or metastasize. * **C. Papilloma:** This is a **benign** epithelial tumor. While it can grow outward (exophytic), it does not show destructive invasion into the underlying stroma. **High-Yield NEET-PG Pearls:** * **Radiological Appearance:** Ameloblastoma typically presents as a **"soap-bubble"** or **"honeycomb"** multilocular radiolucency. * **Histopathology:** Look for "Vickers-Gorlin" criteria—palisading columnar cells with **reverse polarity** (nuclei away from the basement membrane) and central stellate reticulum-like cells. * **Other Locally Malignant Tumors:** Basal Cell Carcinoma (Rodent ulcer), Giant Cell Tumor of bone (Osteoclastoma), and Craniopharyngioma. These are frequent "except" type questions in NEET-PG [1]. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Disorders Involving Inflammatory And Haemopoietic Cells, pp. 644-645. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Head and Neck, p. 741.

Q: Which of the following statements is NOT true regarding Ameloblastoma?

It arises from mesenchymal tissue.. **Explanation** **Ameloblastoma** is a locally aggressive, polymorphic neoplasm of the jaw. The correct answer is **D** because Ameloblastoma is an **epithelial tumor**, not a mesenchymal one [1]. It arises from the dental lamina, the enamel organ, or the epithelial lining of an odontogenic cyst (all ectodermal derivatives). **Analysis of Options:** * **Option A (Most common odontogenic tumor):** This is a true statement. While odontomas are technically more frequent "hamartomas," Ameloblastoma is the most common true odontogenic neoplasm encountered in clinical practice [1]. * **Option B (Generally benign):** This is true. Although it is locally invasive and has a high recurrence rate if not widely excised, it is histologically benign and rarely metastasizes (Malignant Ameloblastoma is a rare exception) [1]. * **Option C (3rd to 5th decades):** This is true. The peak incidence is in middle-aged adults, with no significant gender predilection. **High-Yield Clinical Pearls for NEET-PG:** * **Location:** Most common in the **mandible** (80%), specifically the molar-ramus area. * **Radiology:** Classically presents as a **"Soap-bubble"** or **"Honey-comb"** multilocular radiolucency. * **Histopathology:** Features "Vickers-Gorlin" criteria—palisading columnar cells with **reverse polarity** (nuclei away from the basement membrane) and central **stellate reticulum-like** cells. * **BRAF V600E Mutation:** Frequently associated with the conventional (multicystic) type. * **Treatment:** Wide surgical excision (en bloc resection) is preferred over curettage due to the high risk of recurrence. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Head and Neck, pp. 741-742.

Question 1

All of the following are examples of tumor markers, except?

Accepted Answer

Alpha-HCG (a-HCG)

Answer

Alpha-Feto protein

Answer

Thyroglobulin

Answer

b2-microglobulin

Question 2

A 61-year-old man with a history of chronic viral hepatitis has noted a 6-kg weight loss over the past 5 months. Physical examination shows no masses or palpable lymphadenopathy. An abdominal CT scan shows a nodular liver with a 10-cm mass in the right lobe. A stool guaiac test result is negative. An elevation in which of the following laboratory tests is most likely to be present in this man?

Accepted Answer

Alpha-fetoprotein

Answer

CA-19-9

Answer

Calcitonin

Answer

Carcinoembryonic antigen

Question 3

Which of the following is not a recognized etiology of Kaposi sarcoma?

Accepted Answer

Hereditary

Answer

High-dose radiation

Answer

Human herpes virus-8 (HHV-8)

Answer

HIV

Question 4

Which of the following is least likely to regress spontaneously?

Accepted Answer

Osteosarcoma

Answer

Retinoblastoma

Answer

Choriocarcinoma

Answer

Malignant melanoma

Question 5

Which of the following lesions is described as destructively invasive and locally malignant with rare metastasis?

Accepted Answer

Ameloblastoma

Answer

Fibroma

Answer

Papilloma

Answer

None of the above

Question 6

HER-2/neu gene amplification causes breast carcinoma due to:

Accepted Answer

Overexpression

Answer

Suppression

Answer

Mutation

Answer

Translocation

Question 7

Retinoblastoma is associated with which of the following conditions?

Accepted Answer

Osteosarcoma

Answer

Hepatocellular carcinoma

Answer

Squamous cell carcinoma

Answer

Osteochondroma

Question 8

Which of the following is a component of the Carney triad?

Accepted Answer

Gastric adenocarcinoma

Answer

Paraganglioma

Answer

Pulmonary chondroma

Answer

Bronchogenic carcinoma

Question 9

Which of the following statements is NOT true regarding Ameloblastoma?

Accepted Answer

It arises from mesenchymal tissue.

Answer

It is the most common odontogenic tumor.

Answer

It is generally benign.

Answer

It is common in the 3rd to 5th decades of life.

Question 10

What is the most suggestive sign or symptom of metastatic disease?

Accepted Answer

Paresthesia

Answer

Sudden swelling

Answer

Root resorption

Answer

Diffuse radiolucency

Neoplasia — MCQs

Neoplasia — MCQs

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