Much of her body is prosthetic and she cannot grow much larger than she already is. Pinoko is fairly normal in appearance, but to an extent, she is physically challenged. Regardless, Black Jack treats her as his daughter. She is convinced that she is eighteen years old - the number of years she spent as a teratoma growth - and that she is now Black Jack's wife. She hates being called a child and will insist that she is much older. She is very outspoken and headstrong, but also very stubborn. She works alongside Black Jack as his medical assistant and secretary, which often surprises their patients.

Honma, and in Pinoko's case, she is convinced she is married to Black Jack. In Black Jack's case, he wanted to become a doctor like Dr. Both Pinoko and Black Jack had to undergo serious medical intervention and rehabilitation as young children, and both developed a strong admiration for their carers. In many ways, Pinoko parallels Black Jack in his own childhood. Pinoko's name is derived from Pinocchio, as they are both children who became 'real' after a series of tribulations. Black Jack then adopts the twin, naming her Pinoko. Something compels Black Jack to assemble and rehabilitate this twin, soon helping her look and act like a normal human girl, but the patient's family finds her abhorrent. He soon discovers the growth contains mostly-complete remains of a parasitic twin that merged with the girl in the womb.

In this story, Black Jack is called in to remove a teratoma growth from a teenage girl. Pinoko originally debuted in 1974 via Black Jack chapter 12, 'Teratoid Cystoma'. Black Jack greets Pinoko after her reconstructive surgery

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