Serum Alpha-Fetoprotein and Human Chorionic Gonadotropin in Patients with Seminoma

Abstract

We analyzed the case histories of 31 patients who initially had a diagnosis of seminoma and elevated serum levels of alpha-fetoprotein or human chorionic gonadotropin. We concluded that an elevated alpha-fetoprotein level is firm evidence of the presence of non-seminomatous germ cell tumor and that the patient should be treated accordingly. However, if the level of human chorionic gonadotropin alone is elevated the diagnosis may be either non-seminomatous tumor or seminoma. Patients with seminoma and an elevated level of human chorionic gonadotropin do respond well to radiation therapy if they have low stage disease but if metastatic seminoma is present an elevated human chorionic gonadotropin level appears to be a poor prognostic sign if conventional treatment is given. A plan of treatment is proposed for these patients.

Serum marker potential of placental alkaline phosphatase-like activity in testicular germ cell tumours evaluated by H17E2 monoclonal antibody assay

“…Some investigators have considered the detection of AFP in the serum of patients with metastatic seminoma indicates the appearance of occult teratoma (Lange et al, 1980). Others have regarded the appearance of this marker as supporting the idea that seminoma is an intermediate pathological state which evolves to either AFP-or HCG-secreting teratoma (Raghavan et al, 1982).…”

Pure Testicular Seminoma with Non-Pathologic Elevation of Alpha Fetoprotein: A Case Series

“…In 1980, Lange et al declared "an elevated AFP level is incontrovertible evidence of non-seminomatous tumor and the patient should be treated accordingly" [16] . Apparently, that dictum is facing challenge today, because there is growing evidence of the occurrence of non-pathologic AFP elevations in seminoma patients.…”

Immunohistochemical and Radioimmunological Determination of β-HCG and Pregnancy-Specific β₁_-Protein in Seminomas

“…The absence of AFP in seminomas is a generally rec ognized fact [ 19,21 ]. If a tumor classified as a seminoma by histology proves AFP-positive, it is to be regarded as a mixed tumor with portions of yolk sac tumor [4,14].…”