Page 56 - Eshre 2018

Overview pathology GCNIS related TGCT.
PRE-INVASIVE:
Early gonadal development
seminoma embr. carc.
COMMON PRECURSOR
Blocked PGC/gonocyte (EMBRYONIC GERM CELL)
GCNIS (GB-DSD)
INTRATUBULAR:
70%
~ 7 years
INVASIVE:
PURE or MIXED
seminoma
embr.carc.
teratoma
germ cells
hCG
choriocarc.
PLURIPOTENT (TOTI-/OMNI-)
AFP
yolk sac tum.
Reality about serum AFP & hCG (besides (T)GCT).
?? - UNIVERSAL MARKER - ??
AFP:
hCG:
~ 15 μg/L (~10 kU/L) after the first year of life half-life ~ 4-5 days
may be elevated in: - benign liver
- hepatocellular carcinoma
- gastric, colon, biliary, pancreatic, lung cancers (~20% of patients)
Literature: sensitivity (%)
~ 5 U/L men/pre-menopausal women (post-menopausal women ~10 U/L) half-life (intact) 16-24 hours
TGCT SE NS
may be elevated in: - hydatidiform moles ("molar" pregnancies) - pancreatic adenocarcinomas
AFP 36 3 45
hCG 57 62 66
- islet cell tumors
- tumors of the small and large bowel
- hepatoma, stomach, lung, ovarian, breast and
renal cancer
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