A 52-year-old woman with a long history of laparoscopically confirmed endometriosis develops a complex ovarian mass. Histology shows sheets of large cells with abundant clear cytoplasm and hobnail cells lining gland-like spaces. This malignancy is characterised by which additional clinical association?
- A Markedly elevated CA-125 in all stages
- B Paraneoplastic hypercalcaemia ✓
- C Highest chemosensitivity among epithelial subtypes
- D Association with endometrial hyperplasia
Correct answer: B. Paraneoplastic hypercalcaemia
Explanation
Clear cell carcinoma of the ovary is strongly associated with endometriosis and is the epithelial subtype classically linked to paraneoplastic hypercalcaemia, thought to be mediated by PTHrP production. It is relatively chemoresistant compared with high-grade serous carcinoma, and its CA-125 may be normal even in advanced disease, which kills options A and C.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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