Gastrointestinal surgery: appendiceal neuroendocrine tumour size: 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 · Gastrointestinal surgery: appendiceal neuroendocrine tumour size

Sample item

After appendicectomy for appendicitis, histology shows a 2.5 cm well-differentiated neuroendocrine tumour at the base of the appendix with extension into the caecum. What is the appropriate next step?

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

The answer and the reasoning

D. Right hemicolectomy

Appendiceal neuroendocrine tumours below 1 cm need no further surgery after appendicectomy. Tumours larger than 2 cm, or those at the base or with caecal or mesoappendiceal invasion, carry a significant risk of nodal metastasis and are treated by right hemicolectomy.

Option by option

  • A. No further treatment

    Observation is appropriate only for small tumours, usually below 1 cm, with clear margins.

  • B. Somatostatin analogue therapy alone

    Medical therapy does not replace resection for a localised tumour.

  • C. Completion caecectomy only

    A limited caecal resection does not clear the draining lymph nodes.

  • D. Right hemicolectomy (correct)

    Correct. A tumour larger than 2 cm with base involvement warrants oncological right hemicolectomy.

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, Right hemicolectomy. Appendiceal neuroendocrine tumours below 1 cm need no further surgery after appendicectomy.

Why is "No further treatment" not the answer?

Observation is appropriate only for small tumours, usually below 1 cm, with clear margins.

Why is "Somatostatin analogue therapy alone" not the answer?

Medical therapy does not replace resection for a localised tumour.

Why is "Completion caecectomy only" not the answer?

A limited caecal resection does not clear the draining lymph nodes.

What concept does this question test?

It tests Gastrointestinal surgery: appendiceal neuroendocrine tumour size in General Surgery. Tumours larger than 2 cm, or those at the base or with caecal or mesoappendiceal invasion, carry a significant risk of nodal metastasis and are treated by right hemicolectomy.

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 Gastrointestinal surgery: appendiceal neuroendocrine tumour size?

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.