A 24-year-old woman has a 10 cm complex ovarian mass with markedly elevated LDH, normal AFP, and normal beta-hCG. Intraoperative frozen section shows sheets of uniform cells with clear cytoplasm and central nuclei, separated by fibrous septa with lymphocytes. Which tumor is this?

• A Yolk sac tumor
• B Choriocarcinoma
• C Embryonal carcinoma
• D Dysgerminoma ✓

Explanation

Dysgerminoma shows sheets of uniform polygonal cells with clear cytoplasm and central round nuclei, divided by fibrous septa with lymphocytic infiltrates. It is the female counterpart of seminoma. LDH is elevated, while AFP and beta-hCG are normal (unless syncytiotrophoblastic giant cells are present). Yolk sac tumor produces AFP. Choriocarcinoma produces beta-hCG. Embryonal carcinoma is pleomorphic without the characteristic lymphocytic septa.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.