Bone tumours: desmoid tumour: practice question

A Orthopaedics 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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Orthopaedics · Bone tumours: desmoid tumour

Sample item

A 28-year-old with familial adenomatous polyposis develops a firm, infiltrating mass in the abdominal wall after a laparotomy. Biopsy shows bland spindle cells with nuclear beta-catenin staining. What is the expected behaviour of this tumour?

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

The answer and the reasoning

B. Locally aggressive with frequent recurrence but no distant metastasis

Desmoid tumours (aggressive fibromatosis) are clonal fibroblastic proliferations linked to beta-catenin pathway mutations, often with Gardner syndrome or prior trauma or surgery. They infiltrate muscle and recur after excision, but do not metastasise. Because of high recurrence, wide excision, radiotherapy, systemic therapy or active surveillance are used.

Option by option

  • A. Malignant transformation to osteosarcoma

    Desmoid tumours arise from fibroblasts and do not transform into bone-forming sarcomas.

  • B. Locally aggressive with frequent recurrence but no distant metastasis (correct)

    Correct. They infiltrate locally and recur, but they do not metastasise.

  • C. Early haematogenous spread to the lungs

    Lung metastases are a feature of sarcomas, not of desmoid tumours.

  • D. Spontaneous regression in all cases

    Some stabilise or regress, but many progress and recur, so regression is not guaranteed.

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 Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, Locally aggressive with frequent recurrence but no distant metastasis. Desmoid tumours (aggressive fibromatosis) are clonal fibroblastic proliferations linked to beta-catenin pathway mutations, often with Gardner syndrome or prior trauma or surgery.

Why is "Malignant transformation to osteosarcoma" not the answer?

Desmoid tumours arise from fibroblasts and do not transform into bone-forming sarcomas.

Why is "Early haematogenous spread to the lungs" not the answer?

Lung metastases are a feature of sarcomas, not of desmoid tumours.

Why is "Spontaneous regression in all cases" not the answer?

Some stabilise or regress, but many progress and recur, so regression is not guaranteed.

What concept does this question test?

It tests Bone tumours: desmoid tumour in Orthopaedics. They infiltrate muscle and recur after excision, but do not metastasise. Because of high recurrence, wide excision, radiotherapy, systemic therapy or active surveillance are used.

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 Bone tumours: desmoid tumour?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics 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.