A 16-year-old presents with a 12 cm right ovarian mass. Tumour markers: AFP 2200 ng/mL, beta-hCG 5 IU/L, LDH mildly elevated. What is the most likely diagnosis?
- A Mixed germ cell tumour with embryonal carcinoma
- B Yolk sac tumour (endodermal sinus tumour) ✓
- C Dysgerminoma
- D Immature teratoma grade 3
Correct answer: B. Yolk sac tumour (endodermal sinus tumour)
Explanation
Yolk sac tumour (endodermal sinus tumour) is the classic cause of markedly elevated AFP (often in thousands) in a young female with an ovarian mass; it does not elevate beta-hCG. Dysgerminoma elevates LDH and sometimes hCG but not AFP. Embryonal carcinoma elevates both AFP and hCG. Immature teratoma does not typically produce AFP in such high levels. Yolk sac tumour is highly chemosensitive (BEP regimen).
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.