A 48-year-old woman has a 14 cm multiloculated ovarian mass. Serum CA-125 is 35 U/mL but CEA and CA 19-9 are markedly elevated. Frozen section shows intestinal-type mucinous epithelium with moderate atypia and no stromal invasion. Which statement is correct regarding tumour markers in this lesion?
- A CEA and CA 19-9 are more informative than CA-125 in mucinous ovarian tumours ✓
- B CA-125 is the single most sensitive marker for all mucinous ovarian tumours
- C AFP should be elevated in any borderline mucinous tumour
- D Inhibin B is the preferred marker for mucinous tumours
Correct answer: A. CEA and CA 19-9 are more informative than CA-125 in mucinous ovarian tumours
Explanation
Mucinous ovarian tumours express gastrointestinal-type antigens, so CEA and CA 19-9 are more useful than CA-125, which is raised mainly in non-mucinous epithelial cancers such as serous carcinoma. B normal or mildly elevated CA-125 therefore does not exclude a significant mucinous neoplasm. AFP marks yolk sac tumours and inhibin marks sex cord stromal tumours, neither relevant here.
Reference: Williams Gynecology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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