American Board of Internal Medicine (ABIM) Certification Practice Exam

What is true regarding pure seminomas in terms of serum α-fetoprotein levels?

1. The level is elevated in most cases

2. The level is never elevated

3. The level is significantly decreased

4. The level is only elevated in older patients

The correct answer is: The level is never elevated

Pure seminomas are a type of testicular cancer that are classified within the germ cell tumor category. One of the characteristic features of pure seminomas is their association with serum tumor markers, particularly α-fetoprotein (AFP) and human chorionic gonadotropin (hCG). For pure seminomas, serum α-fetoprotein levels are never elevated. This is a distinguishing factor because elevated AFP levels are typically associated with non-seminomatous germ cell tumors or mixed germ cell tumors, rather than pure seminomas. The lack of elevation in AFP levels in pure seminomas aids in the diagnosis and management of testicular malignancies. In contrast to seminomas, non-seminomatous tumors often show elevated AFP levels, which can complicate the clinical picture if not recognized. Therefore, understanding the specific tumor markers, including the fact that pure seminomas do not elevate α-fetoprotein, is crucial for healthcare professionals in diagnosing and treating testicular cancer effectively.