Signs/Symptoms
Testicular cancer, in 95% of cases, is a solid neoplastic mass. It typically presents as a nodule, or a painless swelling in one testicle.1 The next most common symptom …show more content…
Levels of beta subunit of human corionic gonadotropin and alpha fetoprotein are taken. Levels of lactase dehydrogenase are also measured, but despite it being non specific for testicular cancer it is used as a indicator for the bulk of the disease.
Alpha fetoprotein is a 70 kilodalton single-chain glycoprotein, which in the fetus is synthesised in the liver, GI tract and yolk sac for its role as a major serum binding protein.5 It is related to germ cell tumours as it is produced by yolk sac components, and to a lesser extent embryonal carcinomas and teratomas. It is found in 20%-25% of teratomas, and over 60% of nonseratoma germ cell tumour patients show elevated levels of the protein. It is the most commonly elevated tumour marker for testicular cancer. However, in pure seminoma tumours it is not produced, so it can be an indicator of a mixed tissue tumour.
Human chorionic gonadotropin is a 38 kilodalton protein normally secreted by placental syncytiotrophoblasts that is produced by germ cell tumours. It has two subunits, α and β, but only the β unit is identified by radioimmunoassay techniques.5 Normalisation of the hCG levels after orchiectomy for patients with stage I disease shows evidence that the tumour has been eliminated, but if the levels remain elevated it is a sign there may be a residual disease. It is often only elevated in conjunction with choricarcinomas, embryonal carcinomas or mixed tissue germ cell tumours; and stage I