Tumour markers: testicular germ cell tumours: practice question

A Biochemistry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Biochemistry · Tumour markers: testicular germ cell tumours

Sample item

A 25-year-old man has a testicular mass. Serum AFP is 800 ng/mL and beta-hCG is mildly raised. The orchidectomy specimen is reported as classical seminoma only. How should the marker result be interpreted?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. The raised AFP indicates a non-seminomatous component such as yolk sac tumour, so the tumour is managed as non-seminomatous

Pure seminoma does not produce alpha-fetoprotein; raised AFP indicates yolk sac (endodermal sinus) elements, and such tumours are treated as non-seminomatous germ cell tumours regardless of histology. Seminoma may produce a mildly raised beta-hCG from syncytiotrophoblastic cells. Markers are used for diagnosis, prognosis and follow-up.

Option by option

  • A. Pure seminoma frequently secretes AFP, so the report is consistent

    Pure seminoma does not secrete AFP, so a high value is inconsistent with the report.

  • B. The raised AFP indicates a non-seminomatous component such as yolk sac tumour, so the tumour is managed as non-seminomatous (correct)

    Correct. AFP excludes pure seminoma and demands non-seminoma treatment.

  • C. The AFP indicates a benign epididymal cyst

    A benign epididymal cyst does not produce AFP.

  • D. The AFP is from hepatocellular carcinoma metastasis

    A hepatocellular source is unlikely and the AFP rise is explained by the testicular tumour.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Biochemistry questions

Questions about this Biochemistry question

What is the answer to this Biochemistry question?

The best answer is B, The raised AFP indicates a non-seminomatous component such as yolk sac tumour, so the tumour is managed as non-seminomatous. Pure seminoma does not produce alpha-fetoprotein; raised AFP indicates yolk sac (endodermal sinus) elements, and such tumours are treated as non-seminomatous germ cell tumours regardless of histology.

Why is "Pure seminoma frequently secretes AFP, so the report is consistent" not the answer?

Pure seminoma does not secrete AFP, so a high value is inconsistent with the report.

Why is "The AFP indicates a benign epididymal cyst" not the answer?

A benign epididymal cyst does not produce AFP.

Why is "The AFP is from hepatocellular carcinoma metastasis" not the answer?

A hepatocellular source is unlikely and the AFP rise is explained by the testicular tumour.

What concept does this question test?

It tests Tumour markers: testicular germ cell tumours in Biochemistry. Seminoma may produce a mildly raised beta-hCG from syncytiotrophoblastic cells. Markers are used for diagnosis, prognosis and follow-up.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Tumour markers: testicular germ cell tumours?

Build one table of enzyme deficiency, disease, inheritance and key finding, then revise it by spaced recall. Then use the flashcards and the other Biochemistry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.