A 22-year-old woman has a unilateral 6 cm ovarian mass. Serum AFP is markedly elevated; serum hCG and LDH are normal. The MOST likely histological diagnosis is:
- A Yolk sac tumour (endodermal sinus tumour) ✓
- B Choriocarcinoma
- C Immature teratoma
- D Dysgerminoma
Correct answer: A. Yolk sac tumour (endodermal sinus tumour)
Explanation
Yolk sac tumour (endodermal sinus tumour) is the classic germ cell tumour that secretes AFP, often markedly elevated. Choriocarcinoma elevates hCG. Dysgerminoma elevates LDH and may weakly elevate hCG. Immature teratoma does not characteristically raise AFP (though AFP may be mildly elevated). Schiller-Duval bodies on histology are pathognomonic for yolk sac tumour.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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