Neoplasia: granulosa cell tumour: 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: granulosa cell tumour

Sample item

A 55-year-old postmenopausal woman has vaginal bleeding. Endometrial biopsy shows hyperplasia, and imaging shows a solid adnexal mass. Histology shows cells with grooved, coffee-bean nuclei arranged around small spaces filled with eosinophilic material. Which serum marker is most useful for follow-up?

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

The answer and the reasoning

A. Inhibin

Granulosa cell tumours are sex cord-stromal tumours with Call-Exner bodies and grooved nuclei, and they secrete oestrogen, causing endometrial hyperplasia and sometimes carcinoma. Inhibin is produced by the tumour and is used to monitor recurrence. Late recurrences can occur many years later.

Option by option

  • A. Inhibin (correct)

    Inhibin is secreted by granulosa cell tumours and tracks recurrence.

  • B. CA-125

    CA-125 is mainly raised in epithelial ovarian carcinomas, not in sex cord tumours.

  • C. Alpha-fetoprotein

    Alpha-fetoprotein marks yolk sac tumours and hepatocellular carcinoma.

  • D. Beta-hCG

    Beta-hCG marks choriocarcinoma and some germ cell tumours, and is not secreted by granulosa cells.

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.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is A, Inhibin. Granulosa cell tumours are sex cord-stromal tumours with Call-Exner bodies and grooved nuclei, and they secrete oestrogen, causing endometrial hyperplasia and sometimes carcinoma.

Why is "CA-125" not the answer?

CA-125 is mainly raised in epithelial ovarian carcinomas, not in sex cord tumours.

Why is "Alpha-fetoprotein" not the answer?

Alpha-fetoprotein marks yolk sac tumours and hepatocellular carcinoma.

Why is "Beta-hCG" not the answer?

Beta-hCG marks choriocarcinoma and some germ cell tumours, and is not secreted by granulosa cells.

What concept does this question test?

It tests Neoplasia: granulosa cell tumour in Pathology. Inhibin is produced by the tumour and is used to monitor recurrence. Late recurrences can occur many years later.

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: granulosa cell tumour?

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.