Urology: renal cell carcinoma with caval thrombus: 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 · Urology: renal cell carcinoma with caval thrombus

Sample item

A 60-year-old man has a 9 cm right renal mass with tumour extending as a thrombus up the right renal vein into the inferior vena cava. There are no distant metastases. What is the best treatment?

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

The answer and the reasoning

A. Radical nephrectomy with caval thrombectomy

Renal cell carcinoma has a tendency to grow along the renal vein into the vena cava. Venous extension without metastases is potentially curable by radical nephrectomy with removal of the thrombus.

Option by option

  • A. Radical nephrectomy with caval thrombectomy (correct)

    Correct. Surgery clears both the primary tumour and thrombus in non-metastatic disease.

  • B. Radiotherapy alone

    Renal cell carcinoma is relatively radioresistant.

  • C. Partial nephrectomy

    Partial nephrectomy is for small localised tumours.

  • D. Observation

    Observation allows progression to the heart.

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 General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Radical nephrectomy with caval thrombectomy. Renal cell carcinoma has a tendency to grow along the renal vein into the vena cava.

Why is "Radiotherapy alone" not the answer?

Renal cell carcinoma is relatively radioresistant.

Why is "Partial nephrectomy" not the answer?

Partial nephrectomy is for small localised tumours.

Why is "Observation" not the answer?

Observation allows progression to the heart.

What concept does this question test?

It tests Urology: renal cell carcinoma with caval thrombus in General Surgery. Venous extension without metastases is potentially curable by radical nephrectomy with removal of the thrombus.

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 Urology: renal cell carcinoma with caval thrombus?

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.