Breast and endocrine surgery: papillary carcinoma with lateral nodes: 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: papillary carcinoma with lateral nodes

Sample item

A 35-year-old man has a 2 cm papillary thyroid carcinoma and FNAC-proven metastasis in an enlarged node in the lower jugular chain (level IV). Which operation is most appropriate?

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

The answer and the reasoning

D. Total thyroidectomy with lateral neck dissection of the involved levels

Clinically evident lateral nodal metastases in papillary carcinoma require therapeutic compartment-oriented lateral neck dissection together with total thyroidectomy and central clearance. Nodal disease then receives completion with radioiodine as indicated.

Option by option

  • A. Total thyroidectomy without neck dissection

    Omitting dissection leaves known nodal disease.

  • B. Hemithyroidectomy only

    Lobectomy leaves the opposite lobe and ignores the nodes.

  • C. Radioiodine ablation without surgery

    Radioiodine alone cannot control bulky nodal metastases.

  • D. Total thyroidectomy with lateral neck dissection of the involved levels (correct)

    Correct. Proven lateral nodes need a therapeutic lateral neck dissection with total thyroidectomy.

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 D, Total thyroidectomy with lateral neck dissection of the involved levels. Clinically evident lateral nodal metastases in papillary carcinoma require therapeutic compartment-oriented lateral neck dissection together with total thyroidectomy and central clearance.

Why is "Total thyroidectomy without neck dissection" not the answer?

Omitting dissection leaves known nodal disease.

Why is "Hemithyroidectomy only" not the answer?

Lobectomy leaves the opposite lobe and ignores the nodes.

Why is "Radioiodine ablation without surgery" not the answer?

Radioiodine alone cannot control bulky nodal metastases.

What concept does this question test?

It tests Breast and endocrine surgery: papillary carcinoma with lateral nodes in General Surgery. Nodal disease then receives completion with radioiodine as indicated.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: papillary carcinoma with lateral nodes?

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.