Neoplasia: DES exposure: 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: DES exposure

Sample item

A 19-year-old woman whose mother took diethylstilboestrol during pregnancy is diagnosed with a vaginal tumour. What is the expected histological type?

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

The answer and the reasoning

B. Clear cell adenocarcinoma

In utero DES exposure is associated with vaginal adenosis and clear cell adenocarcinoma of the vagina and cervix in young women. Squamous carcinoma is the common vaginal cancer in older women, and embryonal rhabdomyosarcoma affects infants.

Option by option

  • A. Embryonal rhabdomyosarcoma

    Embryonal rhabdomyosarcoma occurs in girls under 5 as a grape-like mass.

  • B. Clear cell adenocarcinoma (correct)

    Correct. Transplacental DES exposure predisposes to clear cell adenocarcinoma.

  • C. Squamous cell carcinoma

    Squamous carcinoma of the vagina usually arises in older, HPV-exposed women.

  • D. Endometrioid carcinoma

    Endometrioid carcinoma arises in the endometrium of older women.

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 Pathology question

What is the answer to this Pathology question?

The best answer is B, Clear cell adenocarcinoma. In utero DES exposure is associated with vaginal adenosis and clear cell adenocarcinoma of the vagina and cervix in young women.

Why is "Embryonal rhabdomyosarcoma" not the answer?

Embryonal rhabdomyosarcoma occurs in girls under 5 as a grape-like mass.

Why is "Squamous cell carcinoma" not the answer?

Squamous carcinoma of the vagina usually arises in older, HPV-exposed women.

Why is "Endometrioid carcinoma" not the answer?

Endometrioid carcinoma arises in the endometrium of older women.

What concept does this question test?

It tests Neoplasia: DES exposure in Pathology. Squamous carcinoma is the common vaginal cancer in older women, and embryonal rhabdomyosarcoma affects infants.

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: DES exposure?

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.