A 25-year-old woman has a 12 cm ovarian mass with elevated AFP 2500 IU/mL and LDH raised. MRI shows a heterogeneous solid-cystic mass. The most likely diagnosis is:

• A Immature teratoma
• B Dysgerminoma
• C Granulosa cell tumour
• D Endodermal sinus tumour (yolk sac tumour) ✓

Explanation

Endodermal sinus tumour (yolk sac tumour) is the most common malignant ovarian germ cell tumour after dysgerminoma and characteristically secretes alpha-fetoprotein (AFP). AFP levels are dramatically elevated (often >1000 IU/mL) and are used for monitoring response to chemotherapy with BEP (bleomycin, etoposide, cisplatin). Dysgerminoma elevates LDH and β-hCG; granulosa cell tumour elevates inhibin and oestrogen; immature teratoma may mildly elevate AFP.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.