Lactate dehydrogenase (LDH) is a less-specific marker for GCTs, but levels can correlate with overall tumor burden
Beta–human chorionic gonadotropin (beta-hCG) levels are elevated inn 5-10% of patients with seminomas; elevation may correlate with metastatic disease but not with overall survival
Consider this study in any male with a palpable testicular mass that is suspicious or questionable
This study may also be appropriate for males who are at the peak age range for testicular cancer (ie, 15-35 years)
Calcifications and cystic areas are less common in seminomas than in nonseminomatous tumors
Scrotal ultrasonography commonly shows a homogeneous hypoechoic intratesticular mass
Other indications may include acute scrotal pain (especially when associated with a hydrocele), nonspecific scrotal pain, or swelling
Placenta-like alkaline phosphatase levels can be elevated in patients with seminoma, especially as the tumor burden increases; however, it may also increase with smoking
If an asymptomatic hydrocele obscures physical examination of the testicle, this study may be appropriate prior to surgical intervention
Larger lesions may be more inhomogeneous
An elevated AFP level rules out pure seminoma, despite possible contrary histopathologic orchiectomy findings
