A 22-year-old woman has a large unilateral solid ovarian mass. Serum lactate dehydrogenase is markedly elevated. Histology shows sheets of large uniform cells with central nuclei and abundant clear, glycogen-rich cytoplasm, infiltrated by mature lymphocytes. The tumor cells are positive for OCT3/4 and PLAP. What is the diagnosis?
- A Clear cell carcinoma of the ovary
- B Embryonal carcinoma
- C Dysgerminoma ✓
- D Steroid cell tumor
Correct answer: C. Dysgerminoma
Explanation
Dysgerminoma is the female counterpart of testicular seminoma, occurring in young women with elevated LDH as the characteristic marker. It shows sheets of uniform germ cells with glycogen-rich clear cytoplasm and a lymphocytic infiltrate, and expresses OCT3/4 and PLAP. Embryonal carcinoma is CD30 positive and more pleomorphic, while ovarian clear cell carcinoma arises from endometriosis and is not PLAP positive.
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.