A 48-year-old woman with abnormal uterine bleeding is found to have a unilateral solid ovarian mass. Endometrial biopsy shows complex hyperplasia without atypia. The ovarian tumour displays nests of small cuboidal cells with scant cytoplasm around gland-like spaces filled with eosinophilic material and basement membrane-like hyaline cores. Which combination of hormone and marker profile fits this tumour?
- A Androgen secretion with elevated testosterone
- B Oestrogen secretion with elevated inhibin B ✓
- C hCG secretion with elevated lactate dehydrogenase
- D No hormonal activity with elevated CA 125
Correct answer: B. Oestrogen secretion with elevated inhibin B
Explanation
Adult granulosa cell tumour, a sex cord-stromal neoplasm, shows the coffee-bean nuclei and Call-Exner bodies described here. It secretes oestrogen, causing endometrial hyperplasia or carcinoma, and secretes inhibin A, which is a useful serum marker. Androgen excess points instead to Leydig or Sertoli-Leydig cell tumours presenting with virilisation. Dysgerminoma raises LDH, not hCG, and granulosa cell tumours are not CA 125 producing epithelial tumours. Recurrences can occur decades later.
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.