A 22-year-old presents with a rapidly growing right adnexal mass. Serum AFP is markedly elevated; beta-hCG and LDH are normal. On laparotomy, the mass is confined to the right ovary, capsule intact, no peritoneal involvement. Histology shows primitive glandular structures with Schiller-Duval bodies. FIGO stage is IA. Standard postoperative chemotherapy is:

• A Carboplatin monotherapy for 6 cycles
• B BEP (bleomycin, etoposide, cisplatin) for 3 cycles ✓
• C Observation only (surveillance protocol)
• D Paclitaxel-carboplatin for 6 cycles

Explanation

Schiller-Duval bodies (glomerulus-like structures) are pathognomonic of yolk sac tumor (endodermal sinus tumor), which secretes AFP. For malignant germ cell tumors of the ovary (even Stage IA), adjuvant BEP chemotherapy (bleomycin, etoposide, cisplatin) for 3 cycles is standard after fertility-sparing surgery (unilateral salpingo-oophorectomy). Unlike Stage IA dysgerminoma, yolk sac tumor at all stages is treated with chemotherapy because of its aggressive biology.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.