Appendix: neuroendocrine tumour: practice question

A General Surgery 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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General Surgery · Appendix: neuroendocrine tumour

Sample item

A 28-year-old woman has an appendicectomy for acute appendicitis. Histology shows an incidental 8 mm well-differentiated neuroendocrine tumour at the tip, with no mesoappendiceal invasion and clear margins. What is the next step?

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

The answer and the reasoning

D. No further surgery, with routine follow-up

Appendiceal carcinoids are usually found incidentally at the tip. Tumours smaller than 1 cm with clear margins and no adverse features have negligible metastatic potential, so appendicectomy alone is curative. Right hemicolectomy is considered for tumours larger than 2 cm, base involvement, positive margins, lymphovascular invasion or nodal disease.

Option by option

  • A. Octreotide therapy

    Somatostatin analogues are for metastatic functional tumours, which this is not.

  • B. Adjuvant chemotherapy

    Chemotherapy has no role in a completely excised small well-differentiated tumour.

  • C. Right hemicolectomy

    Right hemicolectomy is reserved for tumours above 2 cm or with high-risk features, none of which are present.

  • D. No further surgery, with routine follow-up (correct)

    Small tip tumours with clear margins are cured by the appendicectomy already done.

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 General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, No further surgery, with routine follow-up. Appendiceal carcinoids are usually found incidentally at the tip.

Why is "Octreotide therapy" not the answer?

Somatostatin analogues are for metastatic functional tumours, which this is not.

Why is "Adjuvant chemotherapy" not the answer?

Chemotherapy has no role in a completely excised small well-differentiated tumour.

Why is "Right hemicolectomy" not the answer?

Right hemicolectomy is reserved for tumours above 2 cm or with high-risk features, none of which are present.

What concept does this question test?

It tests Appendix: neuroendocrine tumour in General Surgery. Tumours smaller than 1 cm with clear margins and no adverse features have negligible metastatic potential, so appendicectomy alone is curative. Right hemicolectomy is considered for tumours larger than 2 cm, base involvement, positive margins, lymphovascular invasion or nodal disease.

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 Appendix: neuroendocrine tumour?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.