Neoplasia: germ cell tumours of the ovary: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Neoplasia: germ cell tumours of the ovary

Sample item

A 26-year-old woman has a unilateral ovarian cystic mass found on ultrasound. At surgery it contains hair, sebaceous material and a tooth, and histology shows skin with adnexa, cartilage and gut-type epithelium. Which is the most frequent malignant change arising within such a tumour in adults?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Squamous cell carcinoma from the ectodermal lining

A mature cystic teratoma contains well-differentiated tissues from all three germ layers and is benign. Malignant transformation occurs in about 1 to 2% of cases, and the commonest type is squamous cell carcinoma arising from the skin-like lining. Torsion is the commonest complication overall.

Option by option

  • A. Squamous cell carcinoma from the ectodermal lining (correct)

    Squamous cell carcinoma is the usual malignant transformation, from the keratinising epithelium of the cyst wall.

  • B. Dysgerminoma with sheets of clear cells

    Dysgerminoma is a distinct germ cell tumour of young women and does not arise from a mature teratoma.

  • C. Serous adenocarcinoma of the surface epithelium

    Serous adenocarcinoma arises from the ovarian surface epithelium, not from the tissues of a teratoma.

  • D. Choriocarcinoma of the trophoblastic type

    Choriocarcinoma is a separate germ cell tumour with syncytiotrophoblast and cytotrophoblast and is not the usual transformation of a mature teratoma.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is A, Squamous cell carcinoma from the ectodermal lining. A mature cystic teratoma contains well-differentiated tissues from all three germ layers and is benign.

Why is "Dysgerminoma with sheets of clear cells" not the answer?

Dysgerminoma is a distinct germ cell tumour of young women and does not arise from a mature teratoma.

Why is "Serous adenocarcinoma of the surface epithelium" not the answer?

Serous adenocarcinoma arises from the ovarian surface epithelium, not from the tissues of a teratoma.

Why is "Choriocarcinoma of the trophoblastic type" not the answer?

Choriocarcinoma is a separate germ cell tumour with syncytiotrophoblast and cytotrophoblast and is not the usual transformation of a mature teratoma.

What concept does this question test?

It tests Neoplasia: germ cell tumours of the ovary in Pathology. Malignant transformation occurs in about 1 to 2% of cases, and the commonest type is squamous cell carcinoma arising from the skin-like lining. Torsion is the commonest complication overall.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neoplasia: germ cell tumours of the ovary?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.