Neoplasia: salivary gland tumours: 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 · Neoplasia: salivary gland tumours

Sample item

A 45-year-old woman had enucleation of a painless parotid mass that had grown slowly for five years. Histology showed epithelial and myoepithelial cells in a chondromyxoid stroma. Two years later she has multiple recurrent nodules in the operative bed. What is the best explanation?

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

The answer and the reasoning

A. Tumour projections through an incomplete pseudocapsule were left behind

Pleomorphic adenoma is the commonest salivary gland tumour. Its capsule is thin or incomplete and tumour pseudopods extend beyond it, so enucleation leaves tumour and causes multinodular recurrence. Superficial parotidectomy with facial nerve preservation is the standard operation.

Option by option

  • A. Tumour projections through an incomplete pseudocapsule were left behind (correct)

    Incomplete capsule with pseudopodia explains recurrence after enucleation of a pleomorphic adenoma.

  • B. Perineural spread typical of adenoid cystic carcinoma

    Adenoid cystic carcinoma has a cribriform pattern and is a different tumour from the one described.

  • C. Multifocal origin from intraparotid lymph nodes

    Intraparotid lymph node origin is associated with Warthin tumour, not pleomorphic adenoma.

  • D. Haematogenous seeding from a distant primary

    Pleomorphic adenoma is a primary parotid neoplasm and is not a metastasis from elsewhere.

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 Pathology question

What is the answer to this Pathology question?

The best answer is A, Tumour projections through an incomplete pseudocapsule were left behind. Pleomorphic adenoma is the commonest salivary gland tumour.

Why is "Perineural spread typical of adenoid cystic carcinoma" not the answer?

Adenoid cystic carcinoma has a cribriform pattern and is a different tumour from the one described.

Why is "Multifocal origin from intraparotid lymph nodes" not the answer?

Intraparotid lymph node origin is associated with Warthin tumour, not pleomorphic adenoma.

Why is "Haematogenous seeding from a distant primary" not the answer?

Pleomorphic adenoma is a primary parotid neoplasm and is not a metastasis from elsewhere.

What concept does this question test?

It tests Neoplasia: salivary gland tumours in Pathology. Its capsule is thin or incomplete and tumour pseudopods extend beyond it, so enucleation leaves tumour and causes multinodular recurrence. Superficial parotidectomy with facial nerve preservation is the standard operation.

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 Neoplasia: salivary gland tumours?

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.