Following surgery for an adult granulosa cell tumour of the ovary, which serum marker is most appropriate for serial monitoring of recurrence, given that CA-125 is unreliable for this histotype?
- A Inhibin B ✓
- B AFP
- C CEA
- D CA 19-9
Correct answer: A. Inhibin B
Explanation
Granulosa cell tumours secrete inhibin, and inhibin B in particular rises before clinically detectable recurrence, making it the standard surveillance marker alongside estradiol. Adult granulosa cell tumours also characteristically carry a FOXL2 c.402C>G point mutation, useful diagnostically on histology. AFP marks yolk sac tumours, CEA marks gastrointestinal primaries, and CA 19-9 is a pancreaticobiliary marker. Recurrences of granulosa cell tumour can occur decades after initial surgery, which justifies long-term marker follow-up.
Reference: Williams Gynecology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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