American Board of Internal Medicine (ABIM) Certification Practice Exam

Which tumors are included in nonseminomatous germ cell tumors?

1. Adrenocortical carcinoma

2. Yolk sac tumor

3. Hodgkin's lymphoma

4. Endometrial carcinoma

The correct answer is: Yolk sac tumor

Nonseminomatous germ cell tumors encompass a variety of tumor types derived from germ cells, which are the reproductive cells in the body. Among these, the yolk sac tumor is a well-established member of the nonseminomatous germ cell tumor category. Yolk sac tumors, also known as endodermal sinus tumors, are primarily found in the testes and ovaries. They are characterized by the production of alpha-fetoprotein (AFP), which can serve as a tumor marker and is used to help in diagnosis and monitoring of treatment response. Their classification as nonseminomatous is due to the fact that they exhibit different histological features and clinical management compared to seminomas, which are another category of germ cell tumors. In contrast, adrenocortical carcinoma, Hodgkin's lymphoma, and endometrial carcinoma originate from other types of cells and are thus classified distinctly from germ cell tumors. Adrenocortical carcinoma arises from the adrenal cortex, Hodgkin's lymphoma is a type of lymphatic cancer, and endometrial carcinoma originates from the lining of the uterus. None of these share the germ cell lineage or the specific clinical behavior characteristic of nonseminomatous germ cell tumors, affirming the uniqueness of yol