Anorectal: anal canal 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.

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General Surgery · Anorectal: anal canal carcinoma

Sample item

A patient with HIV has a biopsy-proven squamous cell carcinoma of the anal canal. What is the primary treatment?

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

The answer and the reasoning

C. Chemoradiotherapy with 5-fluorouracil and mitomycin C

Anal canal squamous carcinoma related to HPV is treated by the Nigro protocol of combined chemoradiotherapy, which achieves cure with sphincter preservation in most cases. Abdominoperineal resection is reserved for persistent or recurrent disease. This differs from adenocarcinoma of the rectum.

Option by option

  • A. Chemotherapy alone with no radiotherapy

    Radiotherapy is an essential part of treatment.

  • B. Abdominoperineal resection first

    Radical surgery is kept for salvage.

  • C. Chemoradiotherapy with 5-fluorouracil and mitomycin C (correct)

    Correct. Chemoradiotherapy is first-line.

  • D. Local excision alone for any size

    Local excision suits only small well-differentiated tumours.

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 C, Chemoradiotherapy with 5-fluorouracil and mitomycin C. Anal canal squamous carcinoma related to HPV is treated by the Nigro protocol of combined chemoradiotherapy, which achieves cure with sphincter preservation in most cases.

Why is "Chemotherapy alone with no radiotherapy" not the answer?

Radiotherapy is an essential part of treatment.

Why is "Abdominoperineal resection first" not the answer?

Radical surgery is kept for salvage.

Why is "Local excision alone for any size" not the answer?

Local excision suits only small well-differentiated tumours.

What concept does this question test?

It tests Anorectal: anal canal carcinoma in General Surgery. Abdominoperineal resection is reserved for persistent or recurrent disease. This differs from adenocarcinoma of the rectum.

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 Anorectal: anal canal 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.