title: Pure Stage I Seminoma with an Elevated hCG of 25,265 mIU/ml: A Case Report.
abstract: We report a histologically pure stage 1 seminoma with an elevated human chorionic gonadotropin (hCG). A 38 year-old man was referred for the evaluation of the left testicular swelling. He showed an elevated serum hCG level of 25,265 mIU/ml with normal a fetoprotein and lactate dehydrogenase. Imaging showed heterogeneous tumor without any metastatic lesions. We conducted 4 courses of chemotherapy before detecting hCG nadir. The final pathological report showed pure seminoma with syncytiotrophoblastic cells but no choriocarcinoma components. The patient remains disease free until present time. The case raised several questions regarding diagnosis and treatment strategy for bulky testicular seminoma.
authors.affiliation: Division of Urology, Sendai City Hospital, Sendai, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Katayama
authors.affiliation: Division of Urology, Sendai City Hospital, Sendai, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aoki
authors.affiliation: Division of Urology, Sendai City Hospital, Sendai, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Taguchi
authors.affiliation: Division of Urology, Sendai City Hospital, Sendai, Japan.
authors.forename: Yuu
authors.initials: Y
authors.lastname: Sakurada
authors.affiliation: Division of Urology, Sendai City Hospital, Sendai, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Sato
authors.affiliation: Division of Urology, Sendai City Hospital, Sendai, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Division of Pathology, Sendai City Hospital, Sendai, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Shibuya
authors.affiliation: Division of Pathology, Sendai City Hospital, Sendai, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Naganuma
authors.affiliation: Division of Urology, Sendai City Hospital, Sendai, Japan.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Ishidoya
keywords: Seminoma; Syncytiotrophoblastic cells; hCG