Neoplasia: osteoblastic metastases: practice question

A Pathology 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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Pathology · Neoplasia: osteoblastic metastases

Sample item

A 72-year-old man has back pain and a markedly raised serum alkaline phosphatase. Spine radiographs show multiple dense sclerotic vertebral lesions. Which primary tumour is most likely?

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

The answer and the reasoning

B. Prostatic adenocarcinoma

Prostate cancer typically gives osteoblastic (sclerotic) vertebral metastases, spread partly by the vertebral venous plexus of Batson. Renal cell, thyroid carcinomas and myeloma classically produce lytic lesions.

Option by option

  • A. Renal cell carcinoma

    Renal cell carcinoma metastases are typically lytic and vascular.

  • B. Prostatic adenocarcinoma (correct)

    Correct. Prostate cancer is the classic cause of sclerotic bone metastases.

  • C. Papillary thyroid carcinoma

    Thyroid carcinoma bone metastases are lytic.

  • D. Multiple myeloma

    Myeloma produces punched-out lytic lesions with a normal alkaline phosphatase.

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 Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is B, Prostatic adenocarcinoma. Prostate cancer typically gives osteoblastic (sclerotic) vertebral metastases, spread partly by the vertebral venous plexus of Batson.

Why is "Renal cell carcinoma" not the answer?

Renal cell carcinoma metastases are typically lytic and vascular.

Why is "Papillary thyroid carcinoma" not the answer?

Thyroid carcinoma bone metastases are lytic.

Why is "Multiple myeloma" not the answer?

Myeloma produces punched-out lytic lesions with a normal alkaline phosphatase.

What concept does this question test?

It tests Neoplasia: osteoblastic metastases in Pathology. Renal cell, thyroid carcinomas and myeloma classically produce lytic lesions.

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 Neoplasia: osteoblastic metastases?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology 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.