hCG and CA 125 are normal, however, her serum alkaline phosphatase was found to be elevated

A 20-year female presents with a ovarian mass 6× 6 × 6 cm in size. Ultrasonography reveals solid structures in the mass. Her serum biomarkers such as AFP. hCG and CA 125 are normal, however, her serum alkaline phosphatase was found to be elevated.

Dysgerminoma .M/C tumor in young females is- Germ cell tumor . Hence in this female it could either be a dysgerminoma, endodermal sinus tumor or malignant terotoma, all of which are germ cell tumors (mucinous cystadenocarcinoma is ruled out) The mass in this female has solid component as revealed on USG so it is most probably malignant M/C malignant GCT is dysgerminoma, furthermore in the patient- levels of CA 125 are normal i.e. mucinous cyst adenocarcinoma again ruled out Alpha-fetoprotein is normal, hence endodermal sinus tumor ruled out Alkaline phosphatase is elevated hence diagnosis of dysgerminoma is confirmed

Absolutely wrong, Dysgerminoma will show PLAP, LDH, & sometimes B-hcg increase, whereas Endodermal sinus tumour will be showing increased AFP, HCG