Skin tumours: plexiform neurofibroma: practice question

A Dermatology 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.

Try it

Dermatology · Skin tumours: plexiform neurofibroma

Sample item

A child with NF1 has a soft, ropey, bag-of-worms swelling of the eyelid and temple with overlying hyperpigmentation. Which lesion is this, and what is its main risk?

ADermal neurofibroma, which commonly turns into angiosarcomaBPlexiform neurofibroma, which can transform into malignant peripheral nerve sheath tumourCSolitary schwannoma, which often metastasisesDGranular cell tumour, which carries a high melanoma risk

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

The answer and the reasoning

B. Plexiform neurofibroma, which can transform into malignant peripheral nerve sheath tumour

Plexiform neurofibroma is pathognomonic of NF1, is usually congenital, and involves multiple fascicles with a bag-of-worms feel. A minority undergo malignant change to malignant peripheral nerve sheath tumour, so rapid growth or new pain needs urgent evaluation.

Option by option

A. Dermal neurofibroma, which commonly turns into angiosarcoma
Dermal neurofibromas are benign and do not typically transform to angiosarcoma.
B. Plexiform neurofibroma, which can transform into malignant peripheral nerve sheath tumour (correct)
Correct. Plexiform neurofibroma is characteristic of NF1 and may become malignant peripheral nerve sheath tumour.
C. Solitary schwannoma, which often metastasises
A solitary schwannoma is encapsulated and benign and does not metastasise.
D. Granular cell tumour, which carries a high melanoma risk
Granular cell tumour is a benign Schwann-derived tumour and is not linked with melanoma.

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.

Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is B, Plexiform neurofibroma, which can transform into malignant peripheral nerve sheath tumour. Plexiform neurofibroma is pathognomonic of NF1, is usually congenital, and involves multiple fascicles with a bag-of-worms feel.

Why is "Dermal neurofibroma, which commonly turns into angiosarcoma" not the answer?

Dermal neurofibromas are benign and do not typically transform to angiosarcoma.

Why is "Solitary schwannoma, which often metastasises" not the answer?

A solitary schwannoma is encapsulated and benign and does not metastasise.

Why is "Granular cell tumour, which carries a high melanoma risk" not the answer?

Granular cell tumour is a benign Schwann-derived tumour and is not linked with melanoma.

What concept does this question test?

It tests Skin tumours: plexiform neurofibroma in Dermatology. A minority undergo malignant change to malignant peripheral nerve sheath tumour, so rapid growth or new pain needs urgent evaluation.

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 Skin tumours: plexiform neurofibroma?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology 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.