AFP and ovarian germ cell tumor: In women younger than 40 with an adnexal mass, the Royal College of Obstetricians and Gynecologists recommends obtaining additional tumor marker measurements, including human chorionic gonadotropin, lactate dehydrogenase, and alpha–fetoprotein, due to rare forms of ovarian cancer, such as germ cell tumors of the ovary, and sex cord-stromal tumors that commonly present in younger age groups [6,7].