“…[25][26][27] Ultimately, AFP, hCG, and LDH are only elevated in 26-34%, 38-47%, and 33-44% of men at diagnosis with any TGCT, respectively, 28 making their role in surveillance of men without elevation fraught. In seminoma, the value of serum tumor biomarkers is particularly low, with elevation of AFP, hCG, and LDH seen in <3%, 26,[28][29][30] 18-31%, 26,31 and ~30% 32,33 at diagnosis, respectively, and similarly low rates are also seen at the time of relapse are also seen. 21 In fact, in the event of a significant elevation of serum tumor biomarkers in tumors otherwise thought to represent pure seminoma histologically, the diagnosis is revised from pure seminoma to NSGCT.…”