Laboratory investigation
- Serum AFP may be elevated in >10% of SLCTs, in
particular in retiform subtype.18 Tumor markers are
completed by HCG/ß-HCG to exclude secreting GCT. Serum CA125 can serve
as a sensitive ovarian tumor marker during
follow-up.19 Elevated calcium may indicate ovarian
small cell carcinoma, hypercalcemic type, but may occasionally be seen
in other ovarian tumors. [Level II, Grade A]
- Serum Inhibin and anti-Mullerian hormone, Estradiol, Testosterone,
DHEAS / LH /FSH [Level II, Grade A].
- DICER1 testing should be offered to patients with SLCTs or
gynandroblastoma – after prior genetic counselling [Level II, Grade
A].20
- Testing of thyroid hormones and thyroid ultrasound in cases of SLCTs,
suspected or proven for DICER1 mutation - at diagnosis, and at
regular intervals (e.g. every two years) during follow-up [Level II,
Grade B].3
- Prior to start of chemotherapy, hepatic, hematologic and renal
functions must be evaluated and audiometry should be performed
[Level II, Grade A].