Physical Examination 
• In addition to a careful pelvic exam, a general physical examination should pay particular attention to the 
  lymph nodes above the collarbone, the axillae and the groin.
• An abdominal examination may find an enlarged liver, a mass or masses or excessive fluid (ascites).

Blood and Other Tests 
• Serum beta human chorionic gonadotropin (ßHCG) is elevated in choriocarcinoma . 
• Serum alpha-fetoprotein (AFP) is elevated in endodermal sinus tumors.
• Serum lactate dehydrogenase (LDH) is elevated in dysgerminoma.
• One or more of the tumor markers— serum ßHCG, AFP and LDH—may be elevated in mixed germ cell
  tumors.

Imaging 
• Abdominal and pelvic CT scan . 
• Chest x-ray.

Endoscopy and Biopsy 
• The definitive diagnosis is made on histologic evaluation of the removed ovary.