Endocrine: thyroid 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.

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Pathology · Endocrine: thyroid carcinoma

Sample item

A 72-year-old woman has a rapidly enlarging, hard neck mass for 3 weeks with hoarseness and dysphagia. Biopsy shows pleomorphic spindle and giant cells with numerous mitoses and necrosis. Which statement about the tumour is correct?

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

The answer and the reasoning

D. It is an aggressive undifferentiated carcinoma with a median survival of months

Anaplastic thyroid carcinoma occurs in the elderly, often arising from a longstanding goitre or differentiated carcinoma, and invades locally with a dismal prognosis. TP53 mutations are common. It does not concentrate radioactive iodine.

Option by option

  • A. It arises from parafollicular C cells and secretes calcitonin

    Medullary carcinoma arises from C cells and secretes calcitonin.

  • B. It is a well-differentiated tumour with a 95% 10-year survival

    Papillary carcinoma has excellent long-term survival, unlike this lesion.

  • C. It is cured by radioactive iodine after thyroidectomy

    Anaplastic tumours lose iodine uptake so radioiodine is ineffective.

  • D. It is an aggressive undifferentiated carcinoma with a median survival of months (correct)

    Correct. Anaplastic carcinoma is rapidly fatal, with survival measured in months.

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 D, It is an aggressive undifferentiated carcinoma with a median survival of months. Anaplastic thyroid carcinoma occurs in the elderly, often arising from a longstanding goitre or differentiated carcinoma, and invades locally with a dismal prognosis.

Why is "It arises from parafollicular C cells and secretes calcitonin" not the answer?

Medullary carcinoma arises from C cells and secretes calcitonin.

Why is "It is a well-differentiated tumour with a 95% 10-year survival" not the answer?

Papillary carcinoma has excellent long-term survival, unlike this lesion.

Why is "It is cured by radioactive iodine after thyroidectomy" not the answer?

Anaplastic tumours lose iodine uptake so radioiodine is ineffective.

What concept does this question test?

It tests Endocrine: thyroid carcinoma in Pathology. TP53 mutations are common. It does not concentrate radioactive iodine.

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 Endocrine: thyroid 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.