A 22-year-old woman presents with a 6-week history of rapidly enlarging abdomen, weight loss, and elevated AFP (620 ng/mL) and hCG (1800 mIU/mL). Pelvic ultrasound shows a 15-cm solid right ovarian mass with areas of necrosis. After staging, she receives BEP chemotherapy. Which histological component of her mixed germ cell tumour specifically produces AFP, guiding response monitoring?

• A Dysgerminoma component
• B Choriocarcinoma component
• C Immature teratoma component
• D Yolk sac tumour (endodermal sinus tumour) component ✓

Explanation

AFP (alpha-fetoprotein) is specifically produced by the yolk sac tumour (endodermal sinus tumour) component of mixed germ cell tumours, reflecting its embryonal origin from the vitelline/yolk sac structures. Dysgerminoma is AFP-negative but may rarely elevate LDH and hCG (syncytiotrophoblastic giant cells). Choriocarcinoma produces hCG specifically. Immature teratoma does not produce AFP in significant quantities. Serum AFP kinetics after BEP chemotherapy are used to assess completeness of response specifically to the yolk sac component.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.