Testis

Question 1

What factors elevate beta-hCG?

What cancers have elevated beta-hCG?

Answer 1

hypogonadism, hyperthyroidism and marijuana use, heterophile antibodies
both sem and nonsem (but if >1K in pure sem, consider nonsem) lymphoma, bladder cancer, adenocarcinoma

Question 2

Do pure sems produce AFP?

Answer 2

NO

Question 3

What tumors cause elevated hCG?

Answer 3

Nonsem (choriocarcionma + embryonal), HCC, gastric cancer

Question 4

Beta HCG subunit has cross reactivity with what?

What does this mean?

Answer 4

Leutenizing Hormone
May have elevated testosterone that gets converted to estradiol -> gynecomastia
Men with hypogonadism may have false elevation of HCG

Question 5

How do you manage intra-tubular neoplasia?

Answer 5

Radical orchiectomy, low dose radiation, or close observation

Management depends on fertility desires, want for replacement T, and status of contralateral testis