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Difficulty: EasyGynecologic Oncology

Match each clinical vignette describing a characteristic gynecologic neoplasm with the serum tumor marker most likely to be elevated in that patient.

  • A 15-year-old girl with a rapidly growing ovarian germ cell tumor that histologically reveals Schiller-Duval bodies.Alpha-fetoprotein (AFP)
  • A 28-year-old woman with hemoptysis, multiple lung nodules, and a recent history of a hydatidiform mole evacuation.Beta-human chorionic gonadotropin (beta-hCG)
  • A 20-year-old woman with a solid ovarian tumor composed of uniform cells with clear cytoplasm, resembling a male testicular seminoma.Lactate dehydrogenase (LDH)
  • A 60-year-old woman presenting with postmenopausal bleeding, endometrial hyperplasia, and a unilateral adnexal mass.Inhibin

Answer

The correct matching aligns the yolk sac tumor vignette with AFP, the choriocarcinoma vignette with beta-hCG, the dysgerminoma vignette with LDH, and the granulosa cell tumor vignette with inhibin.
Gynecologic neoplasms have specific histological characteristics, clinical presentations, and secretory profiles. Yolk sac tumors produce alpha-fetoprotein (AFP). Choriocarcinomas are trophoblastic and produce large amounts of beta-hCG. Dysgerminomas are associated with elevated lactate dehydrogenase (LDH). Granulosa cell tumors secrete estrogen and inhibin, making inhibin a highly useful diagnostic marker.

Step-by-Step Solution

1
Analyze the first vignette to identify the underlying neoplasm.
The presence of Schiller-Duval bodies indicates a yolk sac (endodermal sinus) tumor.
Histological findings are highly specific for differentiating ovarian germ cell tumors.
2
Analyze the second vignette to identify the underlying neoplasm.
A recent hydatidiform mole followed by lung metastases describes choriocarcinoma.
Choriocarcinomas often arise from previous molar pregnancies and hematogenously spread to the lungs.
3
Analyze the third vignette to identify the underlying neoplasm.
A tumor resembling a male seminoma in a young woman is a dysgerminoma.
Dysgerminomas are the most common malignant germ cell tumors of the ovary and share histology with seminomas.
4
Analyze the fourth vignette to identify the underlying neoplasm.
Postmenopausal bleeding, endometrial hyperplasia, and an adnexal mass indicate a granulosa cell tumor.
Granulosa cell tumors secrete estrogen, causing endometrial proliferation, and present with concurrent adnexal masses.
5
Match each identified neoplasm with its characteristic serum tumor marker.
Yolk sac tumor pairs with AFP, choriocarcinoma pairs with beta-hCG, dysgerminoma pairs with LDH, and granulosa cell tumor pairs with inhibin.
These are the established biochemical markers for diagnosing and monitoring these specific gynecologic tumors.

Key Concept

Diagnostic tumor markers in gynecologic neoplasms
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Topics

Gynecologic Oncology

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