Nasal and PNS Tumors MCQs

ENT · 30 free questions with answers & explanations.

1. A 50-year-old furniture worker presents with a polypoid nasal mass, progressive nasal obstruction, and CT showing expansion of the left maxillary sinus with medial wall remodelling but no frank bone destruction. Histology shows an inverted papilloma. The most important concern regarding this lesion is:
2. Olfactory neuroblastoma (esthesioneuroblastoma) arises from which cell type, and what is its characteristic radiological appearance on MRI?
3. Sinonasal undifferentiated carcinoma (SNUC) is distinguished from other high-grade sinonasal malignancies by all of the following features EXCEPT:
4. A 55-year-old woodworker presents with a T3N0M0 adenocarcinoma of the ethmoid sinus. This tumour is strongly associated with occupational exposure to:
5. Angiofibroma (JNA) preoperative embolisation is typically performed 24–72 hours before surgery. The most common major complication of endovascular embolisation in this setting is:
6. Nasopharyngeal angiofibroma staging using the Andrews-Fisch-Caversaccio system classifies tumour extension into the pterygomaxillary fossa with intracranial extradural involvement as Stage:
7. A patient with maxillary sinus carcinoma has Sluder's neuralgia as a presenting symptom. This is caused by involvement of which structure?
8. The Öhngren's line in maxillary sinus carcinoma is used to divide tumours into suprastructure and infrastructure. What is this line and what is its clinical significance?
9. A biopsy from a posterosuperior nasal cavity polypoidal lesion shows a trabecular/ribbon-like pattern with hyperchromatic nuclei, salt-and-pepper chromatin, and positive synaptophysin and chromogranin staining. The diagnosis is:
10. An 8-year-old presents with unilateral nasal obstruction, hypernasal speech, and a smooth, fleshy, greyish midline polypoidal mass arising from the roof of the nasopharynx visualised on posterior rhinoscopy. CT shows a well-circumscribed mass extending from the sphenoid sinus. The characteristic feature that distinguishes this from a choanal polyp is:
11. Olfactory neuroblastoma (esthesioneuroblastoma) arises from the olfactory epithelium. The Kadish staging system is used. A patient with tumor involving the nasal cavity, paranasal sinuses, AND regional lymph nodes is classified as:
12. Inverted papilloma of the nasal cavity and paranasal sinuses carries a risk of malignant transformation. The reported rate of synchronous or metachronous squamous cell carcinoma arising from inverted papilloma is approximately:
13. Olfactory neuroblastoma (esthesioneuroblastoma) arises from the olfactory neuroepithelium. The Kadish staging of esthesioneuroblastoma: Stage C is defined as:
14. Inverted papilloma (Schneiderian papilloma, endophytic type) of the nasal cavity and paranasal sinuses is associated with all of the following EXCEPT:
15. Inverted papilloma (Schneiderian papilloma) of the nasal cavity has an endophytic growth pattern where the epithelium inverts into the stroma. The clinical significance of this pattern relates to which of the following features?
16. An olfactory neuroblastoma (esthesioneuroblastoma) is staged using the Kadish staging system. A patient with bilateral nasal cavity involvement extending into the ethmoid sinuses but NOT beyond the nasal cavity/paranasal sinuses is staged as:
17. An inverted papilloma arising from the lateral nasal wall at the middle meatus has the characteristic feature of inverted growth into the subepithelial stroma. The risk of malignant transformation to squamous cell carcinoma and the surgical approach of choice are:
18. Esthesioneuroblastoma (olfactory neuroblastoma) arises from the olfactory neuroepithelium at the cribriform plate. The Kadish staging system Grade C is defined as:
19. A 60-year-old woodworker (exposure to hardwood dust) presents with progressive right-sided nasal obstruction and bloody nasal discharge. CT shows a destructive mass of the right ethmoid sinus. The MOST likely histological type is:
20. Olfactory neuroblastoma (esthesioneuroblastoma) is staged by the Kadish classification. A patient with tumor extending into the orbit and skull base intracranially corresponds to which stage?
21. Which immunohistochemical marker combination is MOST characteristic of olfactory neuroblastoma (esthesioneuroblastoma) distinguishing it from other small round blue cell tumors of the sinonasal region?
22. An inverted papilloma (Schneiderian papilloma) of the nose characteristically arises from the lateral nasal wall. Its unique pathological behaviour includes all of the following EXCEPT:
23. In the modified Kadish staging system for olfactory neuroblastoma (esthesioneuroblastoma), Stage D is defined as:
24. Olfactory neuroblastoma (esthesioneuroblastoma) arises from which cell type, and what is the Kadish staging system criterion for Stage C disease?
25. Inverted papilloma of the nasal cavity has a distinct clinical significance. Which of the following accurately describes its relationship to malignancy and the gold standard surgical approach?
26. Inverted papilloma (Schneiderian papilloma, endophytic type) of the nasal cavity is associated with which of the following clinical concerns that necessitate complete surgical excision with clear margins?
27. An inverted papilloma of the nose is distinct from benign nasal polyps in several ways. The most clinically important feature that mandates complete surgical excision (rather than polypectomy) is:
28. A 55-year-old furniture worker with a history of heavy hardwood dust exposure presents with unilateral nasal obstruction, epistaxis, and a polypoid mass in the nasal cavity. Biopsy reveals sinonasal adenocarcinoma (intestinal type). The most characteristic occupational association is with:
29. A 55-year-old male former woodworker presents with unilateral nasal obstruction, bloody discharge, and CT showing a mass in the ethmoid sinus with bone erosion. Histology reveals papillary structures lined by a mixture of squamous and columnar cells with mitoses. This occupational malignancy is most likely:
30. Inverted papilloma of the nose is associated with all of the following EXCEPT: