A 22-year-old woman has a right ovarian solid-cystic mass. Serum AFP is 1,200 ng/mL and beta-hCG is 4 mIU/mL. Histology shows immature teratoma with endodermal sinus tumour elements. Which tumour marker best monitors response to BEP chemotherapy in this patient?
- A CA-125
- B Beta-hCG
- C Alpha-fetoprotein (AFP) ✓
- D LDH
Correct answer: C. Alpha-fetoprotein (AFP)
Explanation
Endodermal sinus tumour (yolk sac tumour) produces AFP as its primary marker; AFP levels directly reflect tumour burden and response to chemotherapy. In the BEP (bleomycin-etoposide-cisplatin) regimen, serial AFP is the cornerstone of monitoring. CA-125 reflects epithelial ovarian disease; LDH and beta-hCG may be elevated in mixed germ cell tumours but AFP is the dominant marker here.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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Written and medically reviewed by the StethoPrep medical team.