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

Dieckmann, Klaus‐Peter; Anheuser, Petra; Simonsen, Hanna; Höflmayer, Doris

doi:10.1159/000478706

Cited by 9 publications

(14 citation statements)

References 30 publications

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“…However, rates of 30–31% had been reported likewise [47, 48]. AFP was expressed in 60% of nonseminomas, while only isolated patients with seminoma had unspecific elevations of this marker [49]. The expression rate of LDH was also significantly higher in nonseminomas, which represents an unexpected finding [50, 51].…”

Section: Discussionmentioning

confidence: 96%

Testicular Germ-Cell Tumours: A Descriptive Analysis of Clinical Characteristics at First Presentation

et al. 2018

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Introduction: Clinical characteristics of testicular germ cell tumours (GCTs) apparently change over time, and some vary geographically. The aim of this study is to document the clinical profile of contemporary GCT patients. Patients and Methods: Four hundred twenty-two Caucasian GCT-patients treated in one German centre during 2000–2017, were analysed in terms of patient-age, laterality, histology, tumour-size, clinical stages (CS), pathological (pT)-stages and serum biomarker expression. The results were analysed descriptively and compared with the literature. Results: Median age was 36 years and 60.2% had seminoma. Βeta-human chorionic gonadotropin was expressed in 37.9% and alpha Fetoprotein in 25.6%. CS1 presenting stage was 66.6% of all GCT patients, 79.1% in seminoma, and 47.6% in nonseminoma. Tumour size was significantly associated with pT-stages and CS. Patients >50 years had significantly more seminoma (77.6%) than younger ones (57.9%). Comparison with literature data revealed a shifting towards higher age, lower CS, higher proportion of seminoma and striking differences of characteristics among geographic regions. Conclusions: A typical contemporary clinical profile of testicular GCTs is presented in this study. Median age, relative incidence of seminoma and proportion of CS1 appear to be increasing over time. Striking differences among ethnic groups regarding the characteristics of GCT require further investigation.

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Section: Discussionmentioning

confidence: 96%

Testicular Germ-Cell Tumours: A Descriptive Analysis of Clinical Characteristics at First Presentation

et al. 2018

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“…AFP involves a considerably longer half-life of 5–7 days [24-26]. Particularly in CS1 patients with elevated AFP levels, it is sometimes inconvenient to wait for appropriate marker decline to be sure about the stage 1 condition [27]. A half-life of less than 24 h, as found for miR-371a-3p, thus represents a highly useful feature of a serum tumour marker [15].…”

Section: Discussionmentioning

confidence: 99%

The Novel Biomarker of Germ Cell Tumours, Micro-RNA-371a-3p, Has a Very Rapid Decay in Patients with Clinical Stage 1

et al. 2018

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Background: Accumulating evidence suggests serum levels of microRNA (miR)-371a-3p to be a novel tumour marker of testicular germ cell tumours (GCTs). Presently, there is only limited information regarding the velocity of decline of serum levels in response to treatment. Patients and Methods: Twenty-four patients with testicular GCT (20 seminoma, 4 nonseminoma, median age 40 years) with clinical stage 1 had measurements of serum levels of miR-371a-3p preoperatively and repeatedly on the following 3 days. Three had additional tests done within 24 h after surgery. Measurement results were analysed using descriptive statistical methods. Results: Serum levels dropped to 2.62, 1.27, and 0.47% of the preoperative level within 1, 2, and 3 days, respectively. The computed half-life amounts to 3.7–7 h. The velocity of decay is significantly associated with tumour size. Conclusions: Serum-levels of miR-371a-3p have a short half-life of less than 12 h. The rapid decay after treatment represents a valuable feature confirming the usefulness of miR-371a-3p as a valuable serum biomarker of GCT.

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“…However, as for patients with a persistently elevated AFP level, a comprehensive evaluation is required to identify the cause. In our literature review, at least five cases in nonseminomatous GCTs and six cases in seminoma received additional interventions based on a false elevated AFP level [18,26,32,37]. Albany and Einhorn also suggested that patients with an elevated AFP level should not receive salvage chemotherapy unless there is a sustained rise in AFP [48].…”

Section: Discussionmentioning

confidence: 95%

“…In some cases, no etiology was reported, especially in seminoma [31,[33][34][35][36]. Dieckmann et al reported approximately 2% of pure seminoma patients had a non-pathologic AFP elevation, and this proportion was not different from that of controlled patients with non-malignant urologic diseases [32]. In addition, AFP can be expressed in other malignancies, of which HCC is the most frequent, and some nontumor diseases, such as Fanconi anemia and ataxiatelangiectasia [39,40].…”

Section: Discussionmentioning

confidence: 99%

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Persistently elevated alpha-fetoprotein associated with chronic hepatitis B during chemotherapy for malignant ovarian germ cell tumors: a case series and a review of the literature

2019

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Background: Alpha-fetoprotein (AFP) plays a crucial role in the management of malignant ovarian germ cell tumors (MOGCTs) and is an important reference index for chemotherapy termination. However, a high level of AFP can also be caused by several benign diseases, causing confusion and impacting treatment decisions. Case presentation: We described four patients who were diagnosed with MOGCTs; the histologic subtype in two of them was mixed MOGCTs (yolk sac tumor with mature teratoma), while the rest was immature teratoma. The serum AFP level of each patient was abnormal before surgery, but it was still persistently elevated around 300 ng/ ml even after additional cycles of chemotherapy. All patients were thoroughly evaluated, but we did not find any evidence of disease progression or residual tumors. Liver function tests were normal, whereas serum assays revealed positive of hepatitis B surface antigen, and two patients had a high level of HBV-DNA. They were chronic carriers of hepatitis B virus and never received relevant treatments. Then they were managed with tumor surveillance and the antiviral treatment. Thereafter, the AFP levels presented a slowly decreasing trend. Conclusions: False elevation of AFP in MOGCTs is a rare condition and should be assessed with a comprehensive evaluation to avoid unnecessary treatments.

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

Cited by 9 publications

References 30 publications

Testicular Germ-Cell Tumours: A Descriptive Analysis of Clinical Characteristics at First Presentation

Testicular Germ-Cell Tumours: A Descriptive Analysis of Clinical Characteristics at First Presentation

The Novel Biomarker of Germ Cell Tumours, Micro-RNA-371a-3p, Has a Very Rapid Decay in Patients with Clinical Stage 1

Persistently elevated alpha-fetoprotein associated with chronic hepatitis B during chemotherapy for malignant ovarian germ cell tumors: a case series and a review of the literature

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