Neoplasia: acanthosis nigricans as a paraneoplastic sign: practice question

A Pathology 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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Pathology · Neoplasia: acanthosis nigricans as a paraneoplastic sign

Sample item

A 58-year-old man has had rapidly spreading velvety dark thickening of the axillae and neck over two months, with thickened palms showing exaggerated ridges. He is not obese and has normal glucose. Which cancer should be sought first?

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

The answer and the reasoning

C. Gastric adenocarcinoma

Sudden, extensive acanthosis nigricans with tripe palms in a non-obese adult is a cutaneous paraneoplastic sign, most often with gastrointestinal adenocarcinoma, especially gastric. It is thought to result from tumour-secreted growth factors acting on keratinocytes.

Option by option

  • A. Prostate adenocarcinoma

    Prostate cancer is not a recognised major cause of this skin sign.

  • B. Papillary thyroid carcinoma

    Papillary thyroid carcinoma is not typically associated with it.

  • C. Gastric adenocarcinoma (correct)

    Correct. Gastric adenocarcinoma is the commonest associated malignancy.

  • D. Basal cell carcinoma

    Basal cell carcinoma is a local skin tumour with no paraneoplastic effect.

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 Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, Gastric adenocarcinoma. Sudden, extensive acanthosis nigricans with tripe palms in a non-obese adult is a cutaneous paraneoplastic sign, most often with gastrointestinal adenocarcinoma, especially gastric.

Why is "Prostate adenocarcinoma" not the answer?

Prostate cancer is not a recognised major cause of this skin sign.

Why is "Papillary thyroid carcinoma" not the answer?

Papillary thyroid carcinoma is not typically associated with it.

Why is "Basal cell carcinoma" not the answer?

Basal cell carcinoma is a local skin tumour with no paraneoplastic effect.

What concept does this question test?

It tests Neoplasia: acanthosis nigricans as a paraneoplastic sign in Pathology. It is thought to result from tumour-secreted growth factors acting on keratinocytes.

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 Neoplasia: acanthosis nigricans as a paraneoplastic sign?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology 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.