Neoplasia: skin cancers: 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: skin cancers

Sample item

A 45-year-old man has a non-healing ulcer with raised everted edges on a burn scar on his leg that dates back 30 years. What is the most likely diagnosis?

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

The answer and the reasoning

D. Squamous cell carcinoma (Marjolin ulcer)

A Marjolin ulcer is a squamous cell carcinoma arising in a chronic wound, burn scar, sinus or osteomyelitis tract. Latency can be decades, and the tumour is aggressive with a significant risk of nodal metastasis, so biopsy of any chronic ulcer with changing features is needed.

Option by option

  • A. Malignant melanoma

    Melanoma is typically a pigmented lesion, and its presentation on a scar is uncommon.

  • B. Tropical ulcer

    A tropical ulcer is an infective ulcer of the lower leg that does not arise in an old scar after 30 years.

  • C. Basal cell carcinoma

    Basal cell carcinoma usually arises on sun-exposed hair-bearing skin with a pearly rolled edge and rarely metastasises.

  • D. Squamous cell carcinoma (Marjolin ulcer) (correct)

    Malignant change in a long-standing scar with everted edges is typical of Marjolin ulcer.

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, Squamous cell carcinoma (Marjolin ulcer). A Marjolin ulcer is a squamous cell carcinoma arising in a chronic wound, burn scar, sinus or osteomyelitis tract.

Why is "Malignant melanoma" not the answer?

Melanoma is typically a pigmented lesion, and its presentation on a scar is uncommon.

Why is "Tropical ulcer" not the answer?

A tropical ulcer is an infective ulcer of the lower leg that does not arise in an old scar after 30 years.

Why is "Basal cell carcinoma" not the answer?

Basal cell carcinoma usually arises on sun-exposed hair-bearing skin with a pearly rolled edge and rarely metastasises.

What concept does this question test?

It tests Neoplasia: skin cancers in Pathology. Latency can be decades, and the tumour is aggressive with a significant risk of nodal metastasis, so biopsy of any chronic ulcer with changing features is needed.

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: skin cancers?

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.