Paediatric surgery: hepatoblastoma: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Paediatric surgery: hepatoblastoma

Sample item

A 1-year-old has an enlarging upper abdominal mass, with serum alpha-fetoprotein markedly raised and a solitary liver lesion on CT. What is the treatment plan?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Cisplatin-based chemotherapy and surgical resection

Hepatoblastoma is the commonest primary malignant liver tumour in infancy and has markedly raised AFP. Complete surgical resection with cisplatin-based chemotherapy gives good cure rates, with transplant for unresectable disease. It is associated with Beckwith-Wiedemann syndrome and FAP.

Option by option

  • A. Radiotherapy alone

    Radiotherapy is not first-line.

  • B. Cisplatin-based chemotherapy and surgical resection (correct)

    Correct. Chemotherapy plus resection is standard.

  • C. Liver transplantation for all

    Transplant is reserved for unresectable tumours.

  • D. Observation

    Untreated it is fatal.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Cisplatin-based chemotherapy and surgical resection. Hepatoblastoma is the commonest primary malignant liver tumour in infancy and has markedly raised AFP.

Why is "Radiotherapy alone" not the answer?

Radiotherapy is not first-line.

Why is "Liver transplantation for all" not the answer?

Transplant is reserved for unresectable tumours.

Why is "Observation" not the answer?

Untreated it is fatal.

What concept does this question test?

It tests Paediatric surgery: hepatoblastoma in General Surgery. Complete surgical resection with cisplatin-based chemotherapy gives good cure rates, with transplant for unresectable disease. It is associated with Beckwith-Wiedemann syndrome and FAP.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric surgery: hepatoblastoma?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.