Musculoskeletal imaging: expansile lytic metastasis: practice question

A Radiology 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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Radiology · Musculoskeletal imaging: expansile lytic metastasis

Sample item

A 60-year-old man with haematuria has a solitary expansile, lytic, blown-out lesion with a thin shell in the iliac bone. Which primary tumour is most likely?

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

The answer and the reasoning

C. Renal cell carcinoma

Expansile, highly vascular, lytic metastases are typical of renal cell and thyroid carcinoma. Prostate metastases are usually sclerotic, and breast metastases may be lytic, sclerotic or mixed but are rarely blown-out.

Option by option

  • A. Breast carcinoma

    Breast carcinoma metastases are usually lytic, sclerotic or mixed, and not typically expansile and blown-out.

  • B. Gastric carcinoma

    Gastric carcinoma rarely metastasises to bone and does not typically cause expansile lesions.

  • C. Renal cell carcinoma (correct)

    Correct. Blown-out expansile lytic metastasis with haematuria points to renal cell carcinoma.

  • D. Prostate carcinoma

    Prostate carcinoma typically produces osteoblastic metastases.

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 Radiology question

What is the answer to this Radiology question?

The best answer is C, Renal cell carcinoma. Expansile, highly vascular, lytic metastases are typical of renal cell and thyroid carcinoma.

Why is "Breast carcinoma" not the answer?

Breast carcinoma metastases are usually lytic, sclerotic or mixed, and not typically expansile and blown-out.

Why is "Gastric carcinoma" not the answer?

Gastric carcinoma rarely metastasises to bone and does not typically cause expansile lesions.

Why is "Prostate carcinoma" not the answer?

Prostate carcinoma typically produces osteoblastic metastases.

What concept does this question test?

It tests Musculoskeletal imaging: expansile lytic metastasis in Radiology. Prostate metastases are usually sclerotic, and breast metastases may be lytic, sclerotic or mixed but are rarely blown-out.

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 Musculoskeletal imaging: expansile lytic metastasis?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.