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Metastasis – 20 MCQ Quiz
NEET-PG / Medical Entrance Quiz
Topic: Tumor Metastasis
Total Questions: 20
Each question carries 1 mark.
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1. The first major step in local invasion by a malignant tumor is:
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Angiogenesis
Breakdown of basement membrane and extracellular matrix
Extravasation
Colonization of distant organs
2. Which enzyme group is particularly important in degradation of extracellular matrix during tumor invasion?
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Cyclooxygenases
Matrix metalloproteinases
Phospholipases
Aminotransferases
3. Entry of malignant cells into a blood or lymphatic vessel is called:
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Extravasation
Intravasation
Colonization
Transcoelomic spread
4. Exit of circulating tumor cells from a blood vessel into distant tissue is called:
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Intravasation
Invasion
Extravasation
Angiogenesis
5. Which is considered one of the most critical steps determining successful metastasis?
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Primary tumor formation
Colonization of the distant organ
Basement membrane formation
Necrosis of the primary tumor
6. The formation of new blood vessels by a growing metastatic tumor is called:
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Vasculogenesis
Angiogenesis
Intravasation
Embolization
7. Which factor is strongly associated with tumor angiogenesis?
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VEGF
Insulin
Calcitonin
Erythropoietin
8. The three major routes of metastatic spread are:
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Lymphatic, hematogenous and transcoelomic
Neural, muscular and arterial
Venous, arterial and neural
Direct, neural and muscular
9. The most characteristic route of spread of many carcinomas is:
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Lymphatic spread
Neural spread only
Muscular spread
Bone marrow spread
10. Sarcomas classically tend to metastasize predominantly by:
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Lymphatic route
Hematogenous route
Transcoelomic route
Direct mucosal spread
11. Gastrointestinal tract tumors commonly metastasize to the liver because of:
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Systemic arterial circulation
Portal venous circulation
Lymphatic drainage only
Batson venous plexus
12. Prostatic carcinoma commonly spreads to vertebrae through:
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Portal vein
Batson vertebral venous plexus
Pulmonary artery
Thoracic duct
13. Krukenberg tumor refers to:
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Primary ovarian carcinoma
Metastatic tumor to ovary, classically from gastric carcinoma
Metastatic prostate carcinoma to ovary
Primary gastric lymphoma
14. The classical histological component of a Krukenberg tumor is:
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Hepatocytes
Signet-ring cells
Spindle cells
Giant cells
15. Transcoelomic spread means dissemination of tumor cells through:
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Blood vessels
Lymphatic vessels
Body cavities
Peripheral nerves
16. A metastatic tumor generally:
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Always becomes histologically unrelated to its primary
Retains characteristics of the primary tumor
Always becomes a sarcoma
Loses all differentiation
17. Which statement regarding removal of a primary tumor is correct?
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Removal always causes all metastases to regress
Removal never has any therapeutic value
Removal of the primary does not generally cause established metastases to regress
Removal converts metastases into benign tumors
18. Metastatic follicular thyroid carcinoma may be treated with radioactive iodine because the metastatic cells may retain the ability to:
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Produce insulin
Trap iodine
Produce bile
Produce cortisol
19. Which sequence correctly represents the metastatic cascade?
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Angiogenesis → invasion → intravasation → colonization
Invasion → intravasation → survival in circulation → extravasation → colonization
Colonization → invasion → angiogenesis → intravasation
Extravasation → intravasation → invasion → angiogenesis
20. Which mechanism can help circulating tumor cells evade immune destruction?
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Association with platelets
Complete loss of all surface proteins
Conversion into erythrocytes
Destruction of all lymphocytes
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