Pancreas: mucinous cystic neoplasm: 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 · Pancreas: mucinous cystic neoplasm

Sample item

A 44-year-old woman has an incidental 5 cm septated cyst in the tail of the pancreas, with no history of pancreatitis, no communication with the main duct, high cyst fluid CEA and mucin on cytology. What is the most likely diagnosis and management?

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

The answer and the reasoning

D. Mucinous cystic neoplasm, treated by distal pancreatectomy

Mucinous cystic neoplasms occur almost exclusively in middle-aged women, arise in the body or tail, contain ovarian-type stroma, lack ductal communication and have malignant potential, so fit patients undergo resection. Fluid shows mucin and high CEA. Serous cystadenomas are microcystic with a central scar and are benign.

Option by option

  • A. Pseudocyst, treated by cystogastrostomy

    Pseudocyst follows pancreatitis, which is absent here.

  • B. Serous cystadenoma, treated by observation

    Serous cystadenoma has watery fluid with low CEA and a honeycomb pattern, and can be observed.

  • C. Solid pseudopapillary neoplasm, treated by observation

    Solid pseudopapillary neoplasm is a solid-cystic tumour of young women and is resected, not observed.

  • D. Mucinous cystic neoplasm, treated by distal pancreatectomy (correct)

    Correct. A mucinous tail cyst in a woman with high CEA is resected because of malignant potential.

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 General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Mucinous cystic neoplasm, treated by distal pancreatectomy. Mucinous cystic neoplasms occur almost exclusively in middle-aged women, arise in the body or tail, contain ovarian-type stroma, lack ductal communication and have malignant potential, so fit patients undergo resection.

Why is "Pseudocyst, treated by cystogastrostomy" not the answer?

Pseudocyst follows pancreatitis, which is absent here.

Why is "Serous cystadenoma, treated by observation" not the answer?

Serous cystadenoma has watery fluid with low CEA and a honeycomb pattern, and can be observed.

Why is "Solid pseudopapillary neoplasm, treated by observation" not the answer?

Solid pseudopapillary neoplasm is a solid-cystic tumour of young women and is resected, not observed.

What concept does this question test?

It tests Pancreas: mucinous cystic neoplasm in General Surgery. Fluid shows mucin and high CEA. Serous cystadenomas are microcystic with a central scar and are benign.

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 Pancreas: mucinous cystic neoplasm?

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.