Tumor Markers

Question 1

α-fetoprotein

Answer 1

α-fetoprotein is normally made by the fetus, but can also be a marker for endodermal sinus (yolk sac) tumor, embryonal carcinoma, or mixed germ cell tumors. Also hepatocellular carcinoma

Question 2

β-hCG

Answer 2

β-hCG is elevated in hydatidiform moles, invasive moles, and gestational/testicular choriocarcinomas.

Question 3

CA-125

Answer 3

CA-125 is elevated in ovarian tumors.

Question 4

CEA

Answer 4

CEA (carcinoembryonic antigen) is elevated in breast carcinoma, as well as common GI malignancies (colorectal, gastric, and pancreatic cancer).

Question 5

CA-15-3 and CA-27-29

Answer 5

CA-15-3 and CA-27-29 are uniquely elevated in breast carcinoma.

Question 6

LDH

Answer 6

LDH (lactate dehydrogenase) is elevated (nonspecifically) in testicular germ cell tumors.

Question 7

Prostatic acid phosphatase

Answer 7

Prostatic acid phosphatase is elevated (nonspecifically, but most commonly) in prostate carcinoma.

Question 8

PSA

Answer 8

PSA (prostate specific antigen) is elevated in prostate carcinoma, classically producing an increased total PSA with a decreased fraction of free PSA.

Question 9

CA 19-9

Answer 9

CA 19-9 is associated with pancreatic adenocarcinoma, although increased levels can also be seen in gastric, liver, and colon cancers.

Question 10

Desmin

Answer 10

Desmin is associated with rhabdomyosarcoma.

Question 11

S-100

Answer 11

S-100 is associated with
Schwannomas
Neurofibromas
Malignant peripheral nerve sheath tumors (MPST)
Langerhans cell histiocytosis (can be present in pituitary stalk in widespread disease)
Melanoma

Question 12

TRAP

Answer 12

TRAP (tartrate resistant acid phosphatase) is associated with hairy cell leukemia.

Question 13

Mucin production and positive PAS staining

Answer 13

Mucin production and positive PAS staining are associated with Paget’s disease of the vulva/breast. (In contrast with melanoma, Paget’s disease will show cells that are S-100 negative.)