Breast and endocrine surgery: adrenal myelolipoma: 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 · Breast and endocrine surgery: adrenal myelolipoma

Sample item

A 4.5 cm right adrenal mass is found incidentally on CT. It is well circumscribed with attenuation of minus 80 Hounsfield units in most areas, and hormonal screening is normal. What is the diagnosis and management?

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

The answer and the reasoning

B. Myelolipoma, which can be observed

Myelolipomas are benign, hormonally inactive tumours composed of fat and haematopoietic tissue. Macroscopic fat on CT is diagnostic. They are observed unless large and symptomatic or at risk of haemorrhage.

Option by option

  • A. Adrenocortical carcinoma needing adrenalectomy

    Carcinoma is heterogeneous, with calcification and necrosis rather than fat.

  • B. Myelolipoma, which can be observed (correct)

    Correct. Macroscopic fat density identifies a benign myelolipoma.

  • C. Metastasis needing biopsy

    Metastases do not contain fat and screening would not be normal in most.

  • D. Phaeochromocytoma needing alpha blockade

    A phaeochromocytoma is hormonally active and enhances avidly, without fat.

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 B, Myelolipoma, which can be observed. Myelolipomas are benign, hormonally inactive tumours composed of fat and haematopoietic tissue.

Why is "Adrenocortical carcinoma needing adrenalectomy" not the answer?

Carcinoma is heterogeneous, with calcification and necrosis rather than fat.

Why is "Metastasis needing biopsy" not the answer?

Metastases do not contain fat and screening would not be normal in most.

Why is "Phaeochromocytoma needing alpha blockade" not the answer?

A phaeochromocytoma is hormonally active and enhances avidly, without fat.

What concept does this question test?

It tests Breast and endocrine surgery: adrenal myelolipoma in General Surgery. Macroscopic fat on CT is diagnostic. They are observed unless large and symptomatic or at risk of haemorrhage.

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 Breast and endocrine surgery: adrenal myelolipoma?

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.