Serial monitoring of the serum content of the β subunit of human chorionic gonadotropin (βhCG) and α-fetoprotein (αFP) is useful in the initial staging of germ cell tumors and assessing the response to treatment. An increase in either marker during or following treatment almost always heralds disease progression and indicates the need for additional therapy. We report two patients in whom substantial increases in the serum content of AFP occurred during chemotherapy for advanced seminoma. Hepatic dysfunction was present in both patients; in one patient, a chronic carrier of hepatitis B virus, the liver dysfunction was associated with reactivation of hepatitis B manifested by anicteric hepatitis and hepatitis B e antigen positivity. Marked tumor regression had occurred in both patients, and chemotherapy was discontinued in spite of the elevated αFP level. The αFP content in the serum gradually returned to normal, and hepatic dysfunction resolved. Both patients remain free of disease 15 and 17 months following the last chemotherapy treatment. These cases illustrate that hepatic dysfunction and αFP production may occur during chemotherapy and that increases in serum αFP content must be interpreted with caution since the elevated αFP level does not always indicate progression of germ cell tumors.
ASJC Scopus subject areas
- Cancer Research