Obstetrics & Gynaecology · Ovarian Tumors (Benign, Malignant, Classification)

A 45-year-old woman has a right ovarian cyst with a CA-125 of 420 U/mL, a solid component on ultrasound, and elevated LDH. Which serum marker is MOST specific for dysgerminoma among the following?

  • A LDH (lactate dehydrogenase)
  • B CA-125
  • C AFP (alpha-fetoprotein)
  • D β-hCG
Correct answer: A. LDH (lactate dehydrogenase)

Explanation

Dysgerminoma is the most common malignant germ cell tumor and characteristically secretes LDH, particularly LDH-1 isoform. AFP is elevated in yolk sac (endodermal sinus) tumors. β-hCG is elevated in non-gestational choriocarcinoma and mixed germ cell tumors. CA-125 is elevated in epithelial ovarian cancers (especially serous). LDH elevation is the hallmark biochemical marker for dysgerminoma.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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