A 9 yo female presents with a complex adnexal mass and precocious puberty. Which tumor marker is most likely to help with your pre-operative evaluation?
HE-4 (human epididymis protein 4)
CEA (carcinoembryonic antigen)
Multivariate index assay for ovarian cancer
CA-125 is particularly helpful in postmenopausal women
CEA is often elevated with GI malignancies
The multivariate index assay combines menopausal status with 5 tumor markers to determine need for referral to GYN ONC (CA-125, prealbumin, apolipoprotein A-1, beta-2 microglobulin and transferrin). It is used for patients with an adnexal mass over age 18.
Need to look for sources of estrogen when there is precocious puberty.
Granulosa cell tumors often present like this, and inhibin B levels are elevated