An 18-year-old girl presents with rapidly enlarging abdominal mass and markedly elevated serum AFP (2500 ng/mL) and LDH. CT scan shows a large heterogeneous right ovarian mass. Which germ cell tumor is MOST likely and what is its characteristic histological feature?

• A Dysgerminoma; sheets of uniform large cells with fibrous septa containing lymphocytes
• B Immature teratoma; immature neural elements
• C Choriocarcinoma; cytotrophoblasts and syncytiotrophoblasts
• D Yolk sac tumor; Schiller-Duval bodies ✓

Explanation

Yolk sac tumor (endodermal sinus tumor) is the most common malignant germ cell tumor producing AFP, and markedly elevated AFP in a young girl with an ovarian mass strongly suggests this diagnosis. Its pathognomonic histological feature is the Schiller-Duval body, a glomeruloid structure resembling primitive glomeruli. Treatment is BEP chemotherapy (bleomycin, etoposide, cisplatin) after fertility-sparing surgery.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.