Gynaecological oncology: mucinous ovarian tumour: practice question

A OBG 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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OBG · Gynaecological oncology: mucinous ovarian tumour

Sample item

A 40-year-old woman has bilateral mucinous ovarian masses, each about 8 cm, with raised CEA and CA 19-9 and a normal CA-125. What is the most appropriate evaluation?

AAssume bilateral primary ovarian mucinous cancerBMeasure AFPCStart hormone therapyDLook for a gastrointestinal primary including the appendix and colon before attributing to a primary ovarian tumour

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

The answer and the reasoning

D. Look for a gastrointestinal primary including the appendix and colon before attributing to a primary ovarian tumour

Primary mucinous ovarian carcinomas are usually unilateral and large, while bilateral, smaller mucinous tumours are often metastatic from the gastrointestinal tract, such as the appendix, colon or stomach. Raised CEA and CA 19-9 supports this, and pseudomyxoma peritonei may follow a ruptured appendiceal tumour. Endoscopy and imaging are required.

Option by option

A. Assume bilateral primary ovarian mucinous cancer
Primary mucinous tumours are usually unilateral.
B. Measure AFP
AFP is a germ cell marker and not helpful here.
C. Start hormone therapy
Hormone therapy has no role.
D. Look for a gastrointestinal primary including the appendix and colon before attributing to a primary ovarian tumour (correct)
Correct. Bilateral mucinous tumours with raised CEA suggest a gastrointestinal primary.

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.

Questions about this OBG question

What is the answer to this OBG question?

The best answer is D, Look for a gastrointestinal primary including the appendix and colon before attributing to a primary ovarian tumour. Primary mucinous ovarian carcinomas are usually unilateral and large, while bilateral, smaller mucinous tumours are often metastatic from the gastrointestinal tract, such as the appendix, colon or stomach.

Why is "Assume bilateral primary ovarian mucinous cancer" not the answer?

Primary mucinous tumours are usually unilateral.

Why is "Measure AFP" not the answer?

AFP is a germ cell marker and not helpful here.

Why is "Start hormone therapy" not the answer?

Hormone therapy has no role.

What concept does this question test?

It tests Gynaecological oncology: mucinous ovarian tumour in OBG. Raised CEA and CA 19-9 supports this, and pseudomyxoma peritonei may follow a ruptured appendiceal tumour. Endoscopy and imaging are required.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Gynaecological oncology: mucinous ovarian tumour?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG 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.