Thyroid: anaplastic 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 · Thyroid: anaplastic carcinoma

Sample item

A 75-year-old has a rapidly enlarging, hard fixed neck mass with hoarseness and stridor over four weeks. Biopsy shows undifferentiated spindle and giant cells. What is the likely prognosis and treatment aim?

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

The answer and the reasoning

C. Very poor prognosis; palliation with airway protection and radiotherapy

Anaplastic carcinoma is an aggressive tumour of the elderly, with median survival of a few months, and it is usually unresectable at presentation. Management focuses on airway, local control and palliative radiotherapy with or without chemotherapy. Radioiodine is ineffective because the cells do not concentrate iodine.

Option by option

  • A. Cure with lobectomy alone

    Lobectomy cannot cure invasive disease.

  • B. Observation with TSH suppression

    Observation is unsafe given airway compromise.

  • C. Very poor prognosis; palliation with airway protection and radiotherapy (correct)

    Correct. The tumour is lethal and treatment is largely palliative.

  • D. Excellent prognosis with radioiodine

    Radioiodine has no role.

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 General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Very poor prognosis; palliation with airway protection and radiotherapy. Anaplastic carcinoma is an aggressive tumour of the elderly, with median survival of a few months, and it is usually unresectable at presentation.

Why is "Cure with lobectomy alone" not the answer?

Lobectomy cannot cure invasive disease.

Why is "Observation with TSH suppression" not the answer?

Observation is unsafe given airway compromise.

Why is "Excellent prognosis with radioiodine" not the answer?

Radioiodine has no role.

What concept does this question test?

It tests Thyroid: anaplastic carcinoma in General Surgery. Management focuses on airway, local control and palliative radiotherapy with or without chemotherapy. Radioiodine is ineffective because the cells do not concentrate iodine.

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 Thyroid: anaplastic 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.