Breast and endocrine surgery: Hurthle cell carcinoma: 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.

Try it

General Surgery · Breast and endocrine surgery: Hurthle cell carcinoma

Sample item

A 55-year-old woman has a thyroid nodule reported as a Hurthle cell neoplasm on cytology. Lobectomy shows capsular and vascular invasion. Which statement about this tumour is correct?

AIt spreads only by the lymphatic routeBIt arises from the parafollicular C cellsCCytology alone can establish malignancyDIt takes up radioactive iodine poorly

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

The answer and the reasoning

D. It takes up radioactive iodine poorly

Hurthle (oncocytic) cell carcinoma is a variant of follicular carcinoma. Cytology cannot separate benign from malignant disease, because malignancy needs capsular or vascular invasion on histology. These tumours concentrate radioiodine poorly, so response to radioiodine ablation is less than for conventional follicular cancer.

Option by option

A. It spreads only by the lymphatic route
Follicular tumours spread mainly through the blood to bone and lung, not only via lymphatics.
B. It arises from the parafollicular C cells
C-cell origin is true of medullary carcinoma, which secretes calcitonin.
C. Cytology alone can establish malignancy
Cytology cannot diagnose malignancy in follicular-pattern tumours because invasion is needed.
D. It takes up radioactive iodine poorly (correct)
Correct. Poor radioiodine avidity is characteristic and limits adjuvant radioiodine.

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.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, It takes up radioactive iodine poorly. Hurthle (oncocytic) cell carcinoma is a variant of follicular carcinoma.

Why is "It spreads only by the lymphatic route" not the answer?

Follicular tumours spread mainly through the blood to bone and lung, not only via lymphatics.

Why is "It arises from the parafollicular C cells" not the answer?

C-cell origin is true of medullary carcinoma, which secretes calcitonin.

Why is "Cytology alone can establish malignancy" not the answer?

Cytology cannot diagnose malignancy in follicular-pattern tumours because invasion is needed.

What concept does this question test?

It tests Breast and endocrine surgery: Hurthle cell carcinoma in General Surgery. Cytology cannot separate benign from malignant disease, because malignancy needs capsular or vascular invasion on histology. These tumours concentrate radioiodine poorly, so response to radioiodine ablation is less than for conventional follicular cancer.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Breast and endocrine surgery: Hurthle cell carcinoma?

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.