A 35-year-old woman has a 15 cm multiloculated cystic ovarian mass with honeycomb internal echoes. CA-125 is 22 U/mL. Frozen section suggests a mucinous tumour. Which tumour marker panel is most appropriate to support a mucinous epithelial ovarian tumour?
- A CEA and CA 19-9 ✓
- B HE4 alone
- C AFP and LDH
- D Inhibin B and AMH
Correct answer: A. CEA and CA 19-9
Explanation
Mucinous epithelial ovarian tumours characteristically express CEA and CA 19-9, whereas CA-125 is often normal even in frankly malignant mucinous carcinoma, making CA-125 unreliable for this histotype. HE4 also performs poorly for mucinous tumours because ROMA was validated mainly for serous and endometrioid disease. AFP and LDH point toward germ cell tumours, and inhibin with AMH points toward granulosa cell tumours, neither of which fits a mucinous lesion.
Reference: Williams Gynecology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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