Pancreatic and splenic surgery: recognition: 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 · Pancreatic and splenic surgery: recognition

Sample item

A young woman has an incidental large well-circumscribed pancreatic tail mass with mixed cystic and haemorrhagic areas and peripheral calcification. Tumour cells show a CTNNB1 mutation and nuclear beta-catenin. What is the most likely diagnosis?

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

The answer and the reasoning

A. Solid pseudopapillary neoplasm

This low-grade malignant tumour of young women (Frantz tumour) is a large encapsulated mass with degeneration. Resection is usually curative. Serous cystadenoma is a microcystic honeycomb lesion, and mucinous cystic neoplasm has ovarian-type stroma with mucin.

Option by option

  • A. Solid pseudopapillary neoplasm (correct)

    Correct. Young woman, haemorrhagic degeneration and beta-catenin mutation are characteristic.

  • B. Ductal adenocarcinoma

    Ductal adenocarcinoma presents in older patients with an ill-defined hypovascular mass.

  • C. Serous cystadenoma

    Serous cystadenoma shows a microcystic honeycomb with a central scar.

  • D. Mucinous cystic neoplasm

    Mucinous cystic neoplasm has thick-walled macrocysts with mucin.

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 General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Solid pseudopapillary neoplasm. This low-grade malignant tumour of young women (Frantz tumour) is a large encapsulated mass with degeneration.

Why is "Ductal adenocarcinoma" not the answer?

Ductal adenocarcinoma presents in older patients with an ill-defined hypovascular mass.

Why is "Serous cystadenoma" not the answer?

Serous cystadenoma shows a microcystic honeycomb with a central scar.

Why is "Mucinous cystic neoplasm" not the answer?

Mucinous cystic neoplasm has thick-walled macrocysts with mucin.

What concept does this question test?

It tests Pancreatic and splenic surgery: recognition in General Surgery. Resection is usually curative. Serous cystadenoma is a microcystic honeycomb lesion, and mucinous cystic neoplasm has ovarian-type stroma with mucin.

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 Pancreatic and splenic surgery: recognition?

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.