Clinical significance of low level human chorionic gonadotropin in the management of testicular germ cell tumor

The Journal of Urology
Akitoshi TakizawaYoshinobu Kubota

Abstract

The finding of an unexplainable persistent low level of serum human chorionic gonadotropin in the management of testicular cancer sometimes misleads physicians. To avoid unnecessary treatment we suggest a new classification and algorithm for testicular germ cell tumors to discriminate real human chorionic gonadotropin from false-positive results. A total of 24 patients who seemed to have no cancer with an increased but low level of serum human chorionic gonadotropin were evaluated. They included 17 patients with testicular germ cell tumors and 7 with no evidence of germ cell tumor. In these cases parallel serum and urine human chorionic gonadotropin were measured with the same assay and serum human chorionic gonadotropin was measured with a different assay. False-positive cases were identified by critical criteria according to the classification of gestational trophoblastic disease. Of 17 cases of testicular germ cell tumor 12 were classified as false-positive and 5 were classified as true-positive. All of the other 7 cases with no evidence of cancer were classified as phantom cases. Of the 7 patients with phantom human chorionic gonadotropin who had a history of germ cell tumor unnecessary treatments had been performed in 3. A...Continue Reading

Citations

May 15, 2018·International Braz J Urol : Official Journal of the Brazilian Society of Urology·Koji YoshimuraAkitoshi Takizawa

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