Which of the following tumor markers is characteristically elevated in both seminomatous and non-seminomatous germ cell tumors of the testis?

Explanation

## Tumor Markers in Testicular Germ Cell Tumors **Key Point:** LDH is the only marker elevated in both seminomatous and non-seminomatous germ cell tumors; hCG and AFP are specific to non-seminomatous histology. ### Marker Profile by Histology | Marker | Seminoma | Non-Seminoma | Notes | |--------|----------|--------------|-------| | **LDH** | ✓ (30–40%) | ✓ (80%) | Only marker in pure seminoma | | **hCG** | ✗ (rare) | ✓ (choriocarcinoma, embryonal) | Absent in pure seminoma | | **AFP** | ✗ | ✓ (yolk sac, embryonal) | Never elevated in seminoma | ### Clinical Significance - **LDH:** Non-specific but prognostically important; elevated levels indicate higher tumor burden - **hCG & AFP:** Specific for non-seminomatous tumors; their absence does not exclude seminoma - **IGCCCG Prognostic Groups:** LDH is a key stratification factor for risk assessment **High-Yield:** In a seminoma patient with normal hCG and AFP but elevated LDH, the diagnosis is still valid and LDH guides prognosis.