Head and neck tumours: field cancerisation: practice question

A ENT 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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ENT · Head and neck tumours: field cancerisation

Sample item

A 58-year-old smoker treated for early oral cavity cancer returns after 2 years with a new carcinoma in the oesophagus. Which concept best explains this?

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

The answer and the reasoning

D. Field cancerisation of the aerodigestive mucosa exposed to tobacco and alcohol

Chronic carcinogen exposure damages the whole upper aerodigestive mucosa, so patients develop second primary tumours in the oral cavity, pharynx, larynx, lung or oesophagus. This is why follow-up includes examination of the entire field and why smoking cessation is essential.

Option by option

  • A. Metastatic spread through lymphatics

    A separate primary in a different organ is not lymphatic metastasis.

  • B. Residual tumour from inadequate margins

    Inadequate margins cause local recurrence at the same site.

  • C. Radiation-induced sarcoma

    A radiation-induced tumour needs prior radiotherapy to that field.

  • D. Field cancerisation of the aerodigestive mucosa exposed to tobacco and alcohol (correct)

    Correct. The mucosal field is genetically damaged at multiple sites.

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 ENT question

What is the answer to this ENT question?

The best answer is D, Field cancerisation of the aerodigestive mucosa exposed to tobacco and alcohol. Chronic carcinogen exposure damages the whole upper aerodigestive mucosa, so patients develop second primary tumours in the oral cavity, pharynx, larynx, lung or oesophagus.

Why is "Metastatic spread through lymphatics" not the answer?

A separate primary in a different organ is not lymphatic metastasis.

Why is "Residual tumour from inadequate margins" not the answer?

Inadequate margins cause local recurrence at the same site.

Why is "Radiation-induced sarcoma" not the answer?

A radiation-induced tumour needs prior radiotherapy to that field.

What concept does this question test?

It tests Head and neck tumours: field cancerisation in ENT. This is why follow-up includes examination of the entire field and why smoking cessation is essential.

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 Head and neck tumours: field cancerisation?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT 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.