Skin tumours: basal cell carcinoma: practice question

A Pathology 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.

Try it

Pathology · Skin tumours: basal cell carcinoma

Sample item

A 65-year-old farmer has a pearly nodule with telangiectasia and a rolled edge on the nose that has slowly ulcerated. Biopsy shows nests of basaloid cells with peripheral palisading and retraction clefts. Which statement about this tumour is correct?

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

The answer and the reasoning

A. It is locally invasive but rarely metastasises

Basal cell carcinoma, the commonest skin cancer, arises in sun-exposed skin of the face and shows peripheral palisading, clefts and hedgehog pathway mutations (PTCH1). It is locally destructive (rodent ulcer) but metastasis is very rare. Treatment is excision or Mohs surgery.

Option by option

  • A. It is locally invasive but rarely metastasises (correct)

    Basal cell carcinoma invades locally and seldom spreads distantly.

  • B. It arises from Merkel cells

    Merkel cell carcinoma arises from Merkel cells with perinuclear dot-like cytokeratin 20 staining.

  • C. It is caused by activating BRAF mutation

    BRAF V600E is common in melanoma; BCC is driven by hedgehog signalling.

  • D. It frequently metastasises to regional lymph nodes

    Nodal spread is recognised in squamous cell carcinoma and melanoma but is very rare in basal cell carcinoma.

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.

More Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is A, It is locally invasive but rarely metastasises. Basal cell carcinoma, the commonest skin cancer, arises in sun-exposed skin of the face and shows peripheral palisading, clefts and hedgehog pathway mutations (PTCH1).

Why is "It arises from Merkel cells" not the answer?

Merkel cell carcinoma arises from Merkel cells with perinuclear dot-like cytokeratin 20 staining.

Why is "It is caused by activating BRAF mutation" not the answer?

BRAF V600E is common in melanoma; BCC is driven by hedgehog signalling.

Why is "It frequently metastasises to regional lymph nodes" not the answer?

Nodal spread is recognised in squamous cell carcinoma and melanoma but is very rare in basal cell carcinoma.

What concept does this question test?

It tests Skin tumours: basal cell carcinoma in Pathology. It is locally destructive (rodent ulcer) but metastasis is very rare. Treatment is excision or Mohs surgery.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Skin tumours: basal cell carcinoma?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology 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.