American Board of Internal Medicine (ABIM) Certification Practice Exam

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What should be measured along with histologic sampling in suspected testicular cancer?

Serum electrolytes
Serum tumor marker levels
White blood cell count
Urinary protein levels

The correct answer is: Serum tumor marker levels

Measuring serum tumor marker levels is crucial in the assessment of suspected testicular cancer because these markers can provide important information regarding the presence and extent of the disease. In testicular cancer, specific tumor markers such as alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and lactate dehydrogenase (LDH) are often elevated in patients with germ cell tumors. Monitoring these markers can aid not only in diagnosis but also in treatment response evaluation and surveillance for recurrence after treatment. Their levels can assist in differentiating between various types of testicular cancer, guide clinical decision-making, and inform prognosis. For instance, elevated AFP may suggest a non-seminomatous germ cell tumor, while elevated hCG can be seen in both seminomas and non-seminomas. Consequently, following histologic sampling, which identifies the type of cancer present, serum tumor markers provide additional critical information for optimal management and treatment planning.